Reville, Stephen A
Reville, Stephen A is an individual health care provider with primary practice located at 315 Martin Luther King Jr Way , Tacoma WA 98405-4234. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Reville, Stephen A can be contacted via phone (253) 403-4538.Contact Information
Primary practice address
315 Martin Luther King Jr Way
Tacoma WA 98405-4234
Phone: (253) 403-4538
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0420010398 | Vermont |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD60232582 | Washington |
Profile Details
| NPI number | 1336115898 |
|---|---|
| LBN Legal business name | Reville, Stephen A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 24th, 2006 |
| Last updated | Nov 10th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336115898 | NPPES |
| Vermont | MEDICAID | 1008983 |
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