Provider Demographics
NPI:1003985714
Name:STEPHENSON, WILLIAM B (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:STEPHENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MADELYN LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4460
Mailing Address - Country:US
Mailing Address - Phone:207-593-5600
Mailing Address - Fax:207-593-5360
Practice Address - Street 1:7 MADELYN LN
Practice Address - Street 2:SUITE B
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4460
Practice Address - Country:US
Practice Address - Phone:207-593-5600
Practice Address - Fax:207-593-5360
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME015860208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics