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General NPI Number Information
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NPI Number | 1669647137
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Entity Type | Organization
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Legal Business Name | STEPHEN A. CANTOR, M.D., P.C.
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 980 WILLOW CREEK RD SUITE 201
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City | PRESCOTT
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State | AZ
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Zip | 86301-1611
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Country | US
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Telephone | 928-445-4142
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Fax | 928-776-9491
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Provider Business Mailing Address
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Address Line | 980 WILLOW CREEK RD SUITE 201
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City | PRESCOTT
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State | AZ
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Zip | 86301-1611
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Country | US
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Telephone | 928-445-4142
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Fax | 928-776-9491
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JULIE STEVENS
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Credential |
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Telephone | 928-308-4287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 22564
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License Number State | AZ
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