Provider Demographics
NPI:1730231630
Name:TAUBNER, STEPHEN JOSEPH (COF)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:TAUBNER
Suffix:
Gender:M
Credentials:COF
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:185 RATMILL HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:ME
Mailing Address - Zip Code:04352-3823
Mailing Address - Country:US
Mailing Address - Phone:207-685-9990
Mailing Address - Fax:207-685-5330
Practice Address - Street 1:185 RATMILL HILL ROAD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:ME
Practice Address - Zip Code:04352-3823
Practice Address - Country:US
Practice Address - Phone:207-685-9990
Practice Address - Fax:207-685-5330
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
1048310001Medicare ID - Type Unspecified