MEDICARE: DR. STEPHEN SEWELL DASHEF 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	2084P0800X	Psychiatry Physician	39451	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	713458	OTHER	MA	TUFTS HEALTH PLAN
2	11684	OTHER	MA	HEALTH NEW ENGLAND

General Provider Information

NPI Number	:	1558415026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN SEWELL DASHEF MD

Provider Business Mailing Address
First Line	:	78 HARRISON AVENUE
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-2911
Country	:	US
Telephone Number	:	413-584-3580
Fax Number	:	413-587-0959

Provider Business Practice Location Address
First Line	:	57 GOTHIC STREET
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-3047
Country	:	US
Telephone Number	:	413-586-1223
Fax Number	:	413-587-0959

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/08/2007

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