MEDICARE: DR. SHERMAN AURTHUR STEVENSON 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	207Y00000X	Otolaryngology Physician	057327	GA

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

General Provider Information

NPI Number	:	1316935000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERMAN AURTHUR STEVENSON M.D.

Provider Business Mailing Address
First Line	:	3205 SHRINE ROAD
Second Line	:	SUITE 480
City	:	BRUNSWICK
State	:	GA
Zip	:	31520-4722
Country	:	US
Telephone Number	:	912-466-7280
Fax Number	:	912-466-7293

Provider Business Practice Location Address
First Line	:	3205 SHRINE ROAD
Second Line	:	SUITE 480
City	:	BRUNSWICK
State	:	GA
Zip	:	31520-4722
Country	:	US
Telephone Number	:	912-265-3210
Fax Number	:	912-265-1481

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	08/01/2012

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