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Individual

STEPHEN L LISTON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
347 SMITH AVE N, STE 602, SAINT PAUL, MN 55102-2387
(651) 227-0821
(651) 297-6597
Mailing address
2211 PARK AVE, MINNEAPOLIS, MN 55404-3711
(612) 871-1144
(612) 871-2012

Taxonomy

Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
23911
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000010
MEDICA PRIMARY
MN
01
1001957
MEDICA CHOICE
MN
01
100653
UCARE
MN
01
20939
AMERICA'S PPO
MN
01
38T53LI
BLUE SHIELD
MN
01
572001
PREFERRED ONE
MN
Enumeration date
08/24/2005
Last updated
07/08/2007
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