Provider Demographics
NPI:1518269943
Name:STEVENTON, DALE MARSHALL (DO)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:MARSHALL
Last Name:STEVENTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3917 SHIRLEY DR
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2643
Mailing Address - Country:US
Mailing Address - Phone:610-767-1213
Mailing Address - Fax:
Practice Address - Street 1:3917 SHIRLEY DR
Practice Address - Street 2:
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078-2643
Practice Address - Country:US
Practice Address - Phone:610-767-1213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 001947 L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology