Provider Demographics
NPI:1407800576
Name:RATCLIFFE, STEPHEN D (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:RATCLIFFE
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 1:304 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3374
Mailing Address - Country:US
Mailing Address - Phone:717-299-6371
Mailing Address - Fax:717-945-1587
Practice Address - Street 1:304 N WATER ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603
Practice Address - Country:US
Practice Address - Phone:717-299-6371
Practice Address - Fax:717-945-1587
Is Sole Proprietor?:No
Enumeration Date:2006-05-21
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000137390OtherUNISON
PA001445012OtherHIGHMARK
PA89032OtherGEISINGER
PA1417887OtherAETNA-HMO
PA20020512OtherMERCY
PA50082756OtherCAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL
PAP004713OtherGATEWAY
PA2128545000OtherINDEPENDENCE BLUE CROSS
PA4624955OtherAETNA-NON HMO
PA001445012OtherHIGHMARK
PA080191629OtherRR MEDICARE
PA001445012OtherHIGHMARK
PA063954Medicare ID - Type Unspecified