Provider Demographics
NPI:1649257536
Name:DONA, STEPHEN LOUIS (DO)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LOUIS
Last Name:DONA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8934 KINGSRIDGE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1626
Mailing Address - Country:US
Mailing Address - Phone:937-439-6242
Mailing Address - Fax:937-439-6245
Practice Address - Street 1:8934 KINGSRIDGE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-1633
Practice Address - Country:US
Practice Address - Phone:937-439-6242
Practice Address - Fax:937-439-6245
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2011-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34 004752208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0741960Medicaid
OH0741960Medicaid
E36524Medicare UPIN