Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 34.010546 | OH |
Y | 207RH0000X | Hematologist | 44942 | WI |
N | 207RH0000X | Hematologist | 6042 | SD |
NPI | 1134195159 |
---|---|
Provider Name | Stephen C Medlin |
First Address | Milwaukee, WI 53215-3689 |
Second Address | Milwaukee, WI 53215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
047908000 | (05) | MN |
1134195159 | (05) | IA |
1134195159 | ARAZ/ AMERICA'S PPO (01) | SD |
214D7ME | BLUE CROSS (01) | MN |
214D7ME | CC SYSTEMS/ BLUE PLUS (01) | MN |
253094 | MIDLANDS CHOICE (01) | SD |
3600766 | MEDICA (01) | SD |
370624200 | DEPT OF LABOR (01) | SD |
46022474342 | (05) | NE |
4993050 | BLUE CROSS (01) | SD |
57105AH10 | WPS TRICARE (01) | SD |
6042 | DAKOTACARE (01) | SD |
6631870 | (05) | SD |
678061051266 | PREFERRED ONE (01) | SD |
92411422911 | PRIMEWEST (01) | MN |
HP79180 | HEALTHPARTNERS (01) | SD |
I04365 | (02) |