Provider Demographics
NPI:1922180686
Name:STEPHENSON, JANETTE M (MD)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:M
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:216-896-1740
Mailing Address - Fax:216-896-1738
Practice Address - Street 1:3909 ORANGE PL STE 4500
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4487
Practice Address - Country:US
Practice Address - Phone:216-896-1740
Practice Address - Fax:216-896-1738
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074499S207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2244744Medicaid
H48243Medicare UPIN
OH2244744Medicaid