Stephen Ian Bulova, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD010658E Issued in PA

Practice address

4631 Larchwood Ave
Philadelphia, PA 19143-2107

Phone

(215) 747-7441

Fax

(215) 747-7441

NPI assigned

Sep 7, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Delaware Clinical & Laboratory Physicians, PA

  • Hematology (Internal Medicine) Physician
  • Newark, DE
  • NPI 1558440701
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441584000000",
    "number": "1013385178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 LARCHWOOD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191432107",
            "telephone_number": "215-747-7441",
            "fax_number": "215-747-7441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 LARCHWOOD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191432107",
            "telephone_number": "215-747-7441",
            "fax_number": "215-747-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULOVA",
        "first_name": "STEPHEN",
        "middle_name": "IAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-07",
        "last_updated": "2015-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD010658E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Borie Bullock, MD
• Misty Star Bullock
• Oliver C. Bullock, DO
• Sheldon Bullock
• Walter J Bullock, MS
• Mark Bulson
• Eric Bumbaca
• Sandy Bumgardner, PSY.D.
• Kanika Christina Bumpas
• Sovannak Bun, PHARMD

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.