Provider Demographics
NPI:1629575055
Name:IVES, STEPHANIE BEVANS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:BEVANS
Last Name:IVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:LEAH
Other - Last Name:BEVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:813 SHADES CREEK PKWY STE 205
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4512
Mailing Address - Country:US
Mailing Address - Phone:205-578-1799
Mailing Address - Fax:
Practice Address - Street 1:813 SHADES CREEK PKWY STE 250
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4542
Practice Address - Country:US
Practice Address - Phone:055-781-7992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL39087207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology