Provider Demographics
NPI:1598732844
Name:HELLEMS, STEPHEN OLIVER (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:OLIVER
Last Name:HELLEMS
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 1:1561 LONG POND RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4117
Mailing Address - Country:US
Mailing Address - Phone:585-368-6500
Mailing Address - Fax:585-368-6501
Practice Address - Street 1:1561 LONG POND RD
Practice Address - Street 2:SUITE 303
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4117
Practice Address - Country:US
Practice Address - Phone:585-368-6500
Practice Address - Fax:585-368-6501
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY132960207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00734125Medicaid