Stephenson, Sharisse Marie
Stephenson, Sharisse Marie is an individual health care provider with primary practice located at 583 S Clarizz Blvd , Bloomington IN 47401-5515. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Stephenson, Sharisse Marie can be contacted via phone (812) 676-4460.Contact Information
Primary practice address
583 S Clarizz Blvd
Bloomington IN 47401-5515
Phone: (812) 676-4460
Fax: (812) 355-4092
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 233320 | Massachusetts |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 0101281179 | Virginia |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 01090219A | Indiana |
Profile Details
| NPI number | 1538358684 |
|---|---|
| LBN Legal business name | Stephenson, Sharisse Marie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 15th, 2007 |
| Last updated | Oct 3rd, 2024 - about 2 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 | 1538358684 | NPPES |
| Indiana | Other | 090540887 | MEDICARE PTAN |
| Indiana | MEDICAID | 300078531 | MEDICARE PTAN |
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