| Doctor Name: | DR. CAROL MELINDA STEVENS |
| NPI Number: | 1891958898 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | |
| Business Practice Address: | 5100 West Taft Road. Suite 2e Liverpool, NY - 13088 |
| Business Phone Number: | 3156373399 |
| Business Fax Number: | 3156343481 |
| Mailing Address: | Po Box 4868, SYRACUSE |
| State: | NY |
| Postal Code: | 13221 |
| Phone Number: | 3154522500 |
| Fax Number: | 3154522510 |
| NPI Enumeration Date: | 07/09/2008 |
| NPI Last Update Date: | 02/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |