Provider Demographics
NPI:1407897424
Name:BARRON, STEPHEN EDWARD (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:BARRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6490 EXCELSIOR BOULEVARD
Mailing Address - Street 2:MINNESOTA ORTHOPEDICS PA STE W417 MEADOWBROOK MED BLDG
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4705
Mailing Address - Country:US
Mailing Address - Phone:952-925-2388
Mailing Address - Fax:952-925-0743
Practice Address - Street 1:6490 EXCELSIOR BOULEVARD
Practice Address - Street 2:MINNESOTA ORTHOPEDICS PA STE W417 MEADOWBROOK MED BLDG
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4705
Practice Address - Country:US
Practice Address - Phone:952-925-2388
Practice Address - Fax:952-925-0743
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20543207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN30601BAOtherBLUE CROSS BLUE SHIELD MN
MN0925945OtherMEDICA MINNESOTA
924850325020OtherPREFERRED ONE
924850325020OtherPREFERRED ONE