Healthcare Provider Details

I. General information

NPI: 1922329572
Provider Name (Legal Business Name): STEPHEN ANDREW REFSLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BROAD ST
PHILADELPHIA PA
19140-5103
US

IV. Provider business mailing address

201 CEDAR ST SE STE 6600
ALBUQUERQUE NM
87106-5411
US

V. Phone/Fax

Practice location:
  • Phone: 215-707-2000
  • Fax:
Mailing address:
  • Phone: 314-960-4736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD2016-0951
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: