Provider Demographics
NPI:1346208741
Name:STEVENS, RICHARD A (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 PILGRIM RD
Mailing Address - Street 2:
Mailing Address - City:E LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1377
Mailing Address - Country:US
Mailing Address - Phone:413-785-6474
Mailing Address - Fax:
Practice Address - Street 1:190 FIBERLOID ST US POST
Practice Address - Street 2:ASSOC AREA MEDICAL DRIVE
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01152-9402
Practice Address - Country:US
Practice Address - Phone:413-785-6474
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA522052083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine