Provider Demographics
NPI:1982660171
Name:GUY, STEPHEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:R
Last Name:GUY
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 1:900 S DIXIE DR
Mailing Address - Street 2:SUITE 40
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-2657
Mailing Address - Country:US
Mailing Address - Phone:937-890-6644
Mailing Address - Fax:937-890-1726
Practice Address - Street 1:900 S DIXIE DR
Practice Address - Street 2:SUITE 40
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-2657
Practice Address - Country:US
Practice Address - Phone:937-890-6644
Practice Address - Fax:937-890-1726
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35048249207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0536290Medicaid
OH0536290Medicaid
OH0535238Medicare PIN