Provider Demographics
NPI:1740211515
Name:STEVENS, ARTHUR L (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:1201 NOTT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-382-7500
Practice Address - Fax:518-382-7572
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170208207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000401057001OtherBSNENY
NY070124000083OtherFIDELIS
NY11176OtherMVP
NY28N021OtherEMPIRE BC
NY200132OtherSENIOR WHOLE HEALTH
NY01016673Medicaid
NY47360OtherGHI/HMO
NY10001979OtherCDPHP
NY4482289OtherAETNA
NY10001979OtherCDPHP
NYC59410Medicare UPIN