Provider Demographics
NPI:1972748838
Name:REES, STEPHEN DALE
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:DALE
Last Name:REES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 SPRINGCREST DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-1633
Mailing Address - Country:US
Mailing Address - Phone:330-923-2345
Mailing Address - Fax:330-923-8490
Practice Address - Street 1:162 SPRINGCREST DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-1633
Practice Address - Country:US
Practice Address - Phone:330-923-2345
Practice Address - Fax:330-923-8490
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-07
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH775335343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2794365Medicaid