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General NPI Number Information
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NPI Number | 1811151996
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Entity Type | Individual
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Provider Name | STEPHEN RUSSELL PATTEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 300 SE HOSPITAL AVE
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City | STUART
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State | FL
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Zip | 34994-2338
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Country | US
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Telephone | 772-287-5200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3168
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-3168
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Country | US
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Telephone | 855-251-1854
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Fax | 855-270-9738
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35.098619
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME97429
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License Number State | FL
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