Healthcare Provider Details

I. General information

NPI: 1609705037
Provider Name (Legal Business Name): MR. STEPHEN LEE MILHOAN JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 W BAGLEY RD
BEREA OH
44017-1356
US

IV. Provider business mailing address

6603 TROY OVAL
PARMA OH
44129-6341
US

V. Phone/Fax

Practice location:
  • Phone: 440-826-4242
  • Fax:
Mailing address:
  • Phone: 330-421-4671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: