MEDICARE: DR. STEPHEN DAVID GELFOND MD

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	2084P0800X	Psychiatry Physician	E9653	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	260049941	OTHER		RAILROAD MEDICARE

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	:	1467456426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN DAVID GELFOND MD

Provider Business Mailing Address
First Line	:	BROOKE ARMY MEDICAL CENTER
Second Line	:	3551 ROGER BROOKE DR. MCHE- ZQQ
City	:	JBSA FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-916-5503
Fax Number	:

Provider Business Practice Location Address
First Line	:	BROOKE ARMY MEDICAL CENTER
Second Line	:	3551 ROGER BROOKE DR. MCHE- ZQQ
City	:	JBSA FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-915-5503
Fax Number	:

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	08/09/2023

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