Healthcare Provider Details
I. General information
NPI: 1720196223
Provider Name (Legal Business Name): STEPHEN WAYNE MILSTEAD PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/26/2006
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 CHELSEA CORS
CHELSEA AL
35043-7402
US
IV. Provider business mailing address
1033 FOREST BROOK DR
BIRMINGHAM AL
35226-3222
US
V. Phone/Fax
- Phone: 205-678-8878
- Fax:
- Phone: 205-862-6957
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 14407 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: