Gravenstein, Stefan

Gravenstein, Stefan is an individual health care provider with primary practice located at 593 Eddy St , Providence RI 02903. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Gravenstein, Stefan can be contacted via phone (401) 444-5248.

Contact Information

Primary practice address
593 Eddy St Providence RI 02903
Phone: (401) 444-5248
Fax: (401) 444-3397
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 35.120371 Ohio
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X MD12353 Rhode Island

Profile Details

NPI number 1447224191
LBN Legal business name Gravenstein, Stefan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2006
Last updated Nov 25th, 2019 - about 6 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1447224191 NPPES
Ohio MEDICAID 0075808

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