Provider Demographics
NPI:1649208489
Name:KEBE, STEPHEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:KEBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STEPHEN
Other - Middle Name:LOUIS
Other - Last Name:KEBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:275 S VIRGINIA LEE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:OH
Mailing Address - Zip Code:43209
Mailing Address - Country:US
Mailing Address - Phone:614-871-8500
Mailing Address - Fax:614-871-4803
Practice Address - Street 1:275 S VIRGINIA LEE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:OH
Practice Address - Zip Code:43209
Practice Address - Country:US
Practice Address - Phone:614-353-5701
Practice Address - Fax:614-871-4803
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.052735208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0645654Medicaid
OH0645654Medicaid
OH647061OtherUNITED HEALTHCARE OF OHIO