Provider Demographics
NPI:1801819834
Name:YOUMANS, STEPHEN C (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:YOUMANS
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 1:934 DOUGHERTY RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-6515
Mailing Address - Country:US
Mailing Address - Phone:803-643-0588
Mailing Address - Fax:803-643-1776
Practice Address - Street 1:934 DOUGHERTY RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-6515
Practice Address - Country:US
Practice Address - Phone:803-643-0588
Practice Address - Fax:803-643-1776
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF16886207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT11155Medicaid
F61855Medicare UPIN
SCT11155Medicaid