MEDICARE: ELIZABETH CURRIE 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
1	207Q00000X	Family Medicine Physician	000012100	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51500218	OTHER	AL	BXBS

General Provider Information

NPI Number	:	1710041777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH CURRIE STEVENSON M.D.

Provider Business Mailing Address
First Line	:	1 W LAKESHORE DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-0500
Country	:	US
Telephone Number	:	205-930-2950
Fax Number	:	205-930-2957

Provider Business Practice Location Address
First Line	:	4600 HIGHWAY 280
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-5028
Country	:	US
Telephone Number	:	205-408-1231
Fax Number	:	205-408-1229

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	02/15/2010

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