Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 35-053409 | OH |
NPI | 1023002219 |
---|---|
Provider Name | Sigurdur A Stephensen |
First Address | Columbus, OH 43221-2417 |
Second Address | Columbus, OH 43221-2417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0796821 | (05) | OH |
E76638 | (02) |