Stephan, Peter Douglas

Stephan, Peter Douglas is an individual health care provider with primary practice located at 188 E Southway Blvd , Kokomo IN 46902-3650. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Stephan, Peter Douglas can be contacted via phone (765) 453-9000.

Contact Information

Primary practice address
188 E Southway Blvd Kokomo IN 46902-3650
Phone: (765) 453-9000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 053956 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 55024 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01035748A Indiana

Profile Details

NPI number 1548266307
LBN Legal business name Stephan, Peter Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated Aug 3rd, 2022 - about 3 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 1548266307 NPPES
Indiana MEDICAID 01551745
Indiana MEDICAID 624637757A

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