Individual
DR. AUTUMN ELISABETH STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 213-6100
Mailing address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 213-6100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RS20070379
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14257335140
—
AZ
01
—
1427335181
CBQ CLINIC
AZ
05
—
599878
—
AZ
01
—
8HN026
CBQ CLINIC
—
Enumeration date
06/26/2007
Last updated
03/27/2013
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