Provider Demographics
NPI:1225004468
Name:FIELD, STEPHEN IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:IRA
Last Name:FIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:28333 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1687
Mailing Address - Country:US
Mailing Address - Phone:586-776-9770
Mailing Address - Fax:586-776-9772
Practice Address - Street 1:28333 HARPER AVE
Practice Address - Street 2:
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1687
Practice Address - Country:US
Practice Address - Phone:586-776-9770
Practice Address - Fax:586-776-9772
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301036599207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1502807Medicare ID - Type Unspecified
MIA77303Medicare UPIN