Dr. Mary Bernona Stevens
Dentist - General Practice
1172 Nixon Ave Nw
Grand Rapids
, Michigan 49544-3638
Dr. Mary Bernona Stevens
Dentist - General Practice
1172 Nixon Ave Nw
Grand Rapids
, Michigan 49544-3638
(616) 453-0640
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About
Features
Specialties
- General Practice
Languages spoken
- English
Location
First Address
- Dr. Mary Bernona Stevens
- 1172 Nixon Ave Nw
- Grand Rapids, MI
- Zip : 49534-3638
- Fax : (616) 453-0640
- Phone : (616) 453-0644
Second Address
- Dr. Mary Bernona Stevens
- 1172 Nixon Ave Nw
- Grand Rapids, MI
- Zip : 49544-3638
- Fax : (616) 453-0640
- Phone : (616) 453-0644
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223G0001X | General Practice | 12849 | MI |
| Y | 213EG0000X | General Practice | 12849 | MI |
National Provider Identifier
| NPI | 1003819004 |
|---|---|
| Provider Name | Dr. Mary Bernona Stevens |
| First Address | Grand Rapids, MI 49534-3638 |
| Second Address | Grand Rapids, MI 49544-3638 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/05/2005 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.