MEDICARE: JEFFREY A STEVENS D.O.

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	207RH0003X	Hematology & Oncology Physician	OS010067L	PA

General Provider Information

NPI Number	:	1659371383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY A STEVENS D.O.

Provider Business Mailing Address
First Line	:	101 E OLNEY AVE STE 400
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-2470
Country	:	US
Telephone Number	:	215-456-1825
Fax Number	:	215-456-5926

Provider Business Practice Location Address
First Line	:	5501 OLD YORK RD STE 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-3018
Country	:	US
Telephone Number	:	215-456-3880
Fax Number	:	215-456-3437

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	06/04/2024

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