Doctor Name: | DR. STEPHEN J. CHEYNE |
NPI Number: | 1346391513 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | M4566 |
Business Practice Address: | 430 N Bridge St Saint Anthony, ID - 834451425 |
Business Phone Number: | 2086244402 |
Business Fax Number: | 2086244409 |
Mailing Address: | Po Box 37, SAINT ANTHONY |
State: | ID |
Postal Code: | 834450037 |
Phone Number: | 2086244402 |
Fax Number: | 2086244409 |
NPI Enumeration Date: | 01/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | M4566 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |