Individual
STEPHEN R STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 PLEASANT ST., STE. 306, DES MOINES, IA 50309-1453
(515) 241-5926
(515) 241-5127
Mailing address
1215 PLEASANT ST., STE. 306, DES MOINES, IA 50309-1453
(515) 241-5926
(515) 241-5127
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
35187
IA
2080P0207X
Pediatric Hematology & Oncology Physician
G31607
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508850496
—
IA
01
—
175150045
MEDICARE
—
Enumeration date
09/07/2005
Last updated
11/17/2011
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