Individual
DR. DEREK ALLEN STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1103 WEST SHERMAN AVENUE, BUILDING 2 UNIT C, VINELAND, NJ 08360
(856) 362-5259
(856) 405-6978
Mailing address
1103 WEST SHERMAN AVENUE, BUILDING 2 UNIT C, VINELAND, NJ 08360
(856) 362-5259
(856) 405-6978
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA09618900
NJ
208600000X
Surgery Physician
R70529
AZ
390200000X
Student in an Organized Health Care Education/Training Program
ME116873
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0475025
—
NJ
Enumeration date
06/24/2008
Last updated
12/31/2019
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