Stephen Wesley London, M.D.

Individual provider Active NPI Anesthesiology Physician · Oak Bluffs, MA

NPI 1487744868 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487744868
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
47283 (MA)
Practice address
1 Hospital Road
Oak Bluffs, MA 02557
Phone
(508) 693-9012
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20111103000661 HI Practitioner - Anesthesiology 0143493346 Practice locations: Honolulu, HI; Kahului, HI

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47283MAMDAnesthesiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 47283 MA Yes

Addresses

Primary practice location

1 Hospital Road
Oak Bluffs, MA 02557

Mailing address

PO Box 4291
Vineyard Haven, MA 02568-0932
Phone (508) 693-7578

Other providers in Oak Bluffs, MA

All providers in Oak Bluffs, MA · Anesthesiology Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.