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NPI Code Detail

MEDICARE: DR. STEPHANIE DENISE STEVENSON M.D.

MEDICARE: DR. STEPHANIE DENISE STEVENSON 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
12084P0800XPsychiatry Physician4301052949MI

General Provider Information

NPI Number : 1659456184
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE DENISE STEVENSON M.D.
Provider Business Mailing Address
First Line : 17971 HAMILTON RD
Second Line :
City : DETROIT
State : MI
Zip : 48203-1708
Country : US
Telephone Number : 313-341-7035
Fax Number : 313-864-0173
Provider Business Practice Location Address
First Line : 24424 W MCNICHOLS RD
Second Line :
City : DETROIT
State : MI
Zip : 48219-3653
Country : US
Telephone Number : 313-531-2500
Fax Number : 313-255-1795
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 09/13/2022

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