Doctor Name: | DR. PAUL G STEVENS |
NPI Number: | 1992914089 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 208D00000X |
Business Practice Address: | 39 Ala Malama St. Kaunakakai, HI - 967481100 |
Business Phone Number: | 8085535353 |
Business Fax Number: | 8085534269 |
Mailing Address: | P.o. Box 1100, 39 Ala Malama St. KAUNAKAKAI |
State: | HI |
Postal Code: | 967481100 |
Phone Number: | 8085535353 |
Fax Number: | 8085534269 |
NPI Enumeration Date: | 05/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 208D00000X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |