Individual
KATHLEEN D STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14519 DETROIT AVE, LAKEWOOD, OH 44107-4316
(216) 521-4200
Mailing address
PO BOX 951101, CLEVELAND, OH 44193-0005
(440) 879-0081
(440) 879-0084
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35-045869
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000348268
ANTHEM
OH
05
—
0560067
—
OH
Enumeration date
10/18/2005
Last updated
07/12/2007
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