Individual
DR. DAVID J. STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
637 S. WALKER STREET, SUITE 2, BLOOMINGTON, IN 47403-2175
(812) 332-1977
(812) 332-1981
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01069799A
IN
207R00000X
Internal Medicine Physician
MD2004-0516
NM
207RR0500X
Rheumatology Physician
Primary
01069799A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000728700
ANTHEM PIN
IN
05
—
201035800
—
IN
Enumeration date
08/30/2006
Last updated
02/27/2014
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