MEDICARE: ROBERT L. STEPHENSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	RS029828	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	0F37296001	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	381867275	OTHER		PPOM
2	381867275	OTHER		GREAT LAKES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	381867275	OTHER		AETNA
5	381867275	OTHER		CIGNA
6	381867275	OTHER		HARRINGTON BENEFITS
7	381867275	OTHER		WPS TRICARE FOR LIFE
8	0F37296	OTHER	MI	BCBSM
9	180F372960	OTHER	MI	BLUE CARE NETWORK
10	381867275	OTHER		UNITED HEALTHCARE
11	C4175	OTHER		MCARE
13	381867275	OTHER		FIRST HEALTH
14	B45467	OTHER		HAP

General Provider Information

NPI Number	:	1073507869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT L. STEPHENSON M.D.

Provider Business Mailing Address
First Line	:	800 S ADAMS RD
Second Line	:	SUITE 201
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7005
Country	:	US
Telephone Number	:	248-644-8060
Fax Number	:	248-644-5081

Provider Business Practice Location Address
First Line	:	800 S ADAMS RD
Second Line	:	SUITE 201
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7005
Country	:	US
Telephone Number	:	248-644-8060
Fax Number	:	248-644-5081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	03/02/2010

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