Provider Demographics
NPI:1366538068
Name:PEARSON, STEPHEN HILDING (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:HILDING
Last Name:PEARSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9277 HAWKCREST CT
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-4827
Mailing Address - Country:US
Mailing Address - Phone:301-642-3006
Mailing Address - Fax:
Practice Address - Street 1:9277 HAWKCREST CT
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-4827
Practice Address - Country:US
Practice Address - Phone:301-642-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN617892085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology