Provider Demographics
NPI:1710963707
Name:CONTAG, STEPHEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:CONTAG
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 1:606 24TH AVE S STE 400
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1517
Mailing Address - Country:US
Mailing Address - Phone:612-273-2223
Mailing Address - Fax:612-273-2224
Practice Address - Street 1:606 24TH AVE S STE 400
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1517
Practice Address - Country:US
Practice Address - Phone:612-273-2223
Practice Address - Fax:612-273-2224
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00228207V00000X, 207VM0101X
MDD68363207VM0101X
MN45694207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC189349OtherMEDCOST
MD022528200Medicaid
WV3810009876Medicaid
NC5904845Medicaid
NC142JYOtherBCBS
VA10405114Medicaid
SCQ0022EMedicaid
NC7429837OtherAETNA
MN786183400Medicaid
NC808933OtherPARTNERS
VA10405114Medicaid
MN786183400Medicaid
WV3810009876Medicaid
H88660Medicare UPIN
SCQ0022EMedicaid
2060181AMedicare PIN