Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2179 | WV |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 34-00-4412 | OH |
NPI | 1578504171 |
---|---|
Provider Name | Stephen E. Popper |
First Address | Springfield, OH 45505-1410 |
Second Address | Springfield, OH 45505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 07/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000185223 | UNISON MEDICAID (01) | OH |
000000283924 | ANTHEM BCBS (01) | |
1057734 | BWC (01) | WV |
2411321 | (05) | OH |
2411321 | MOLINA MEDICAID (01) | OH |
3004121000 | (05) | WV |
310917085146 | CARESOURCE MEDICAID (01) | OH |
H84867 | (02) |