Provider Demographics
NPI:1588662407
Name:SCHLOSS, STEPHEN B (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:B
Last Name:SCHLOSS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:131 ORNAC
Mailing Address - Street 2:SUITE 740/50
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4181
Mailing Address - Country:US
Mailing Address - Phone:978-369-5551
Mailing Address - Fax:978-369-1580
Practice Address - Street 1:131 ORNAC
Practice Address - Street 2:SUITE 740/50
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-369-5551
Practice Address - Fax:978-369-1580
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2010-11-22
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Provider Licenses
StateLicense IDTaxonomies
MA52760208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110075576AMedicaid
MA110075576AMedicaid
MAJ04307Medicare PIN