Provider Demographics
NPI:1235142969
Name:HELGEMO, STEPHEN L JR (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:HELGEMO
Suffix:JR
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 1:18344 MURDOCK CIR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1008
Mailing Address - Country:US
Mailing Address - Phone:941-625-6547
Mailing Address - Fax:941-629-6415
Practice Address - Street 1:18344 MURDOCK CIR
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1008
Practice Address - Country:US
Practice Address - Phone:941-625-6547
Practice Address - Fax:941-629-6415
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0072747207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
5294520OtherETNA
FL279078500Medicaid
P00267480OtherRAIL ROAD MEDICARE
21069OtherBLUE CROSS BLUE SHEILD
280461OtherWELLCARE HMO
FL279078500Medicaid
P00267480OtherRAIL ROAD MEDICARE
21069OtherBLUE CROSS BLUE SHEILD