MEDICARE: STEPHEN HUGH MACDONALD DO

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	2083X0100X	Occupational Medicine Physician	OS6246	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245230978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN HUGH MACDONALD DO

Provider Business Mailing Address
First Line	:	3300 S FISKE BLVD
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1223 GATEWAY DR STE 2H
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-2607
Country	:	US
Telephone Number	:	321-725-4500
Fax Number	:	321-434-8881

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	10/31/2018

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Directions to “ STEPHEN HUGH MACDONALD DO” Practice Location

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