Healthcare Provider Details

I. General information

NPI: 1447221197
Provider Name (Legal Business Name): STEPHEN M WINTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 STEVENS ST
NORWALK CT
06850-3852
US

IV. Provider business mailing address

24 STEVENS ST
NORWALK CT
06850-3852
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-2392
  • Fax: 203-852-3436
Mailing address:
  • Phone: 203-852-2392
  • Fax: 203-852-3436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number025653
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number025653
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number025653
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: