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1255493565

NPI Code Detail

MEDICARE: DR. STEPHEN ROGER SETTERBERG MD

MEDICARE: DR. STEPHEN ROGER SETTERBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	36051	MN
2	2084P0804X	Child & Adolescent Psychiatry Physician	G-147958	CA
3	2084P0800X	Psychiatry Physician	36051	MN
4	2084P0800X	Psychiatry Physician	G-147958	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	152T45E	OTHER	ND	BCBC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255493565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN ROGER SETTERBERG MD

Provider Business Mailing Address
First Line	:	12915 63RD AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-6001
Country	:	US
Telephone Number	:	763-383-5800
Fax Number	:	763-383-5801

Provider Business Practice Location Address
First Line	:	3010 COLBY ST STE 221
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2056
Country	:	US
Telephone Number	:	844-763-3560
Fax Number	:	510-680-1849

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	12/13/2025

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Directions to “ DR. STEPHEN ROGER SETTERBERG MD” Practice Location

Language	Start Address	Practice Location

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