MEDICARE: STEPHEN R. BICKEL 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	207R00000X	Internal Medicine Physician	G38493	CA
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	G38493	CA
3	2083P0901X	Public Health & General Preventive Medicine Physician	G38493	CA
4	207R00000X	Internal Medicine Physician	ME113895	FL

General Provider Information

NPI Number	:	1912094319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN R. BICKEL M.D.

Provider Business Mailing Address
First Line	:	301 DR. CARTER BLVD
Second Line	:
City	:	BUNNELL
State	:	FL
Zip	:	32110-0847
Country	:	US
Telephone Number	:	386-437-7350
Fax Number	:	386-437-7353

Provider Business Practice Location Address
First Line	:	301 DR CARTER BLVD
Second Line	:
City	:	BUNNELL
State	:	FL
Zip	:	32110-6212
Country	:	US
Telephone Number	:	386-437-7350
Fax Number	:	386-437-7353

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	11/18/2022

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