Vance, Stephen Glenn

Vance, Stephen Glenn is an individual health care provider with primary practice located at 21 Montauk Ave , New London CT 06320-4906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Vance, Stephen Glenn can be contacted via phone (860) 439-6400.

Contact Information

Primary practice address
21 Montauk Ave New London CT 06320-4906
Phone: (860) 439-6400
Fax: (860) 271-4797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 051723 Connecticut

Profile Details

NPI number 1215909379
LBN Legal business name Vance, Stephen Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Feb 24th, 2016 - about 9 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 1215909379 NPPES
Indiana MEDICAID 200821230
Indiana MEDICAID 64076672

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