Provider Demographics
NPI:1336169788
Name:STEVENS, SCOTT M (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5169 S COTTONWOOD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6768
Mailing Address - Country:US
Mailing Address - Phone:801-507-3747
Mailing Address - Fax:801-507-3350
Practice Address - Street 1:5169 S COTTONWOOD ST STE 300
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6768
Practice Address - Country:US
Practice Address - Phone:801-507-3747
Practice Address - Fax:801-507-3350
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2019-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT3222041205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine