MEDICARE: DR. STEPHEN DAHMER M.D.

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	207Q00000X	Family Medicine Physician	239225	NY
2	202D00000X	Integrative Medicine Physician	72250	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	239225	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1508956798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN DAHMER M.D.

Provider Business Mailing Address
First Line	:	6860 E SUNRISE DR STE 100
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-0733
Country	:	US
Telephone Number	:	520-694-1042
Fax Number	:

Provider Business Practice Location Address
First Line	:	6860 E SUNRISE DR STE 100
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-0733
Country	:	US
Telephone Number	:	520-694-1042
Fax Number	:

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	01/19/2025

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Directions to “ DR. STEPHEN DAHMER M.D.” Practice Location

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