Provider Demographics
NPI:1689765976
Name:EPPES, STEPHEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
Last Name:EPPES
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:A.I. DUPONT HOSPITAL FOR CHILDREN
Practice Address - Street 2:1600 ROCKLAND ROAD
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-4000
Practice Address - Fax:302-651-4945
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC100029802080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5032601Medicaid
IA510057Medicaid
MD7722010Medicaid
PA1217317Medicaid
VA6062130Medicaid
NY1486171Medicaid
077295SAJMedicare PIN
F49280Medicare UPIN
NJ5032601Medicaid