Provider Demographics
NPI:1932291895
Name:VERBECK, STEPHEN ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ROBERT
Last Name:VERBECK
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 1:95 ARCH ST
Mailing Address - Street 2:STE. 100
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304
Mailing Address - Country:US
Mailing Address - Phone:330-253-1800
Mailing Address - Fax:330-253-3955
Practice Address - Street 1:95 ARCH ST
Practice Address - Street 2:STE. 100
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304
Practice Address - Country:US
Practice Address - Phone:330-253-1800
Practice Address - Fax:330-253-3955
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046964V207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0608999Medicaid
OHVE9259851OtherMEDICARE ID
OH0572353OtherMEDICARE ID
OH0572353OtherMEDICARE ID