Edstrom, Stephen Blackstone

Edstrom, Stephen Blackstone is an individual health care provider with primary practice located at 4881 Sugar Maple Dr , Wright Patterson Afb OH 45433-5529. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Student, Health Care / Student in an Organized Health Care Education/Training Program is his primary health care specialty. Edstrom, Stephen Blackstone can be contacted via phone (937) 257-0837.

Contact Information

Primary practice address
4881 Sugar Maple Dr Wright Patterson Afb OH 45433-5529
Phone: (937) 257-0837
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 01066091A Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01066091A Indiana

Profile Details

NPI number 1396942264
LBN Legal business name Edstrom, Stephen Blackstone
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2007
Last updated Mar 1st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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