MEDICARE: DR. STEPHEN MICHAEL DUBUC D.C.

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	111N00000X	Chiropractor	X007495	NY

General Provider Information

NPI Number	:	1508867359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN MICHAEL DUBUC D.C.

Provider Business Mailing Address
First Line	:	2293 SAUNDERS SETTLEMENT RD
Second Line	:
City	:	SANBORN
State	:	NY
Zip	:	14132-9336
Country	:	US
Telephone Number	:	716-297-9123
Fax Number	:	716-297-6717

Provider Business Practice Location Address
First Line	:	2293 SAUNDERS SETTLEMENT RD
Second Line	:
City	:	SANBORN
State	:	NY
Zip	:	14132-9336
Country	:	US
Telephone Number	:	716-297-9123
Fax Number	:	716-297-6717

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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