Provider Demographics
NPI:1104888163
Name:STEVENS, FLOYD C JR (DO)
Entity type:Individual
Prefix:
First Name:FLOYD
Middle Name:C
Last Name:STEVENS
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:1480 W CENTER RD
Practice Address - Street 2:SUITE 5
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732-2143
Practice Address - Country:US
Practice Address - Phone:989-895-4625
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101005165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1004143OtherMCLAREN HEALTH PLAN
MI1004143OtherHEALTH ADVANTAGE
MI3072649Medicaid
MI0118935OtherHEALTHPLUS
MIE25873OtherHEALTH NET FEDERAL SERVIC
MI0850918934OtherBLUE CROSS BLUE SHIELD
MI1004143OtherMCLAREN HEALTH PLAN
MIE25873Medicare UPIN