Individual
STEVAN I HIMMELSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1211 UNION AVE STE 965, MEMPHIS, TN 38104
(901) 435-8550
(901) 516-0933
Mailing address
P O BOX 1000 DEPT 960, MEMPHIS, TN 38148-0001
(901) 435-8550
(901) 516-0933
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
12664
MS
207RC0000X
Cardiovascular Disease Physician
20638
TN
207RI0011X
Interventional Cardiology Physician
12664
MS
207RI0011X
Interventional Cardiology Physician
Primary
20638
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115478
—
MS
05
—
117357001
—
AR
05
—
3807173
—
TN
01
—
6092182
BCBS
TN
Enumeration date
12/27/2005
Last updated
06/25/2018
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