Individual
DR. MARILOU V STEPHAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3333 HAZELTON RD, EDINA, MN 55435-4204
(952) 926-6149
(952) 926-2729
Mailing address
3333 HAZELTON RD, EDINA, MN 55435-4204
(952) 926-6149
(952) 926-2729
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN1770
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12083
COLE MANAGED VISION CARE
MN
01
—
22-20201
MEDICA/UNITED HEALTH CARE
MN
01
—
23750
AMERICA'S PPO
MN
01
—
85601ST
BCBS OF MN
MN
01
—
MN 1770
EYEMED VISION CARE
MN
01
—
ST794518
CLARITY VISION
MN
Enumeration date
06/28/2005
Last updated
07/08/2007
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