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NPI Code Detail

MEDICARE: DR. STEPHEN DOUGLAS HART PHD

MEDICARE: DR. STEPHEN DOUGLAS HART PHD
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
11041C0700XClinical Social Worker487 123WI

Other Identifiers

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

General Provider Information

NPI Number : 1306934476
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN DOUGLAS HART PHD
Provider Business Mailing Address
First Line : 7330 W LAYTON AVE
Second Line : AMERICAN BEHAVIORAL CLINICS SC
City : MILWAUKEE
State : WI
Zip : 53220-3849
Country : US
Telephone Number : 414-281-1677
Fax Number : 414-281-9884
Provider Business Practice Location Address
First Line : 7330 W LAYTON AVE
Second Line : AMERICAN BEHAVIORAL CLINICS SC
City : MILWAUKEE
State : WI
Zip : 53220-3849
Country : US
Telephone Number : 414-281-1677
Fax Number : 414-281-9884
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 07/08/2007

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