Provider Demographics
NPI:1851332472
Name:NAYLOR, STEPHEN (DO)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:NAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 WOODVIEW RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9314
Mailing Address - Country:US
Mailing Address - Phone:610-345-1900
Mailing Address - Fax:410-378-9922
Practice Address - Street 1:455 WOODVIEW RD STE 100
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9314
Practice Address - Country:US
Practice Address - Phone:610-345-1900
Practice Address - Fax:410-378-9922
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD914802700Medicaid
MDH04876Medicare UPIN
MD345MMedicare PIN
MD345MMedicare PIN