Stephen Mark Shall, DDS is a medicare enrolled "Oral & Maxillofacial Surgery" provider in Sylvania, Ohio. His current practice location is
5690 Monroe St, Sylvania, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 479-3939.
Stephen Mark Shall is licensed to practice in Ohio (license number 30.016634) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1215932504.
Healthcare Provider's Profile
| Full Name | Stephen Mark Shall |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 5690 Monroe St, Sylvania, Ohio |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Stephen Mark Shall attended and graduated from in
NPI Data:
- NPI Number: 1215932504
- Provider Enumeration Date: 06/15/2005
- Last Update Date: 08/01/2019
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Stephen Mark Shall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215932504 | NPI | - | NPPES |
| 0515599 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 16634 (Ohio) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 30.016634 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stephen Mark Shall is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Stephen Mark Shall, DDS
5690 Monroe St, Ste A,
Sylvania, OH 43560-2736
Ph: (419) 479-3939 | Stephen Mark Shall, DDS
5690 Monroe St,
Sylvania, OH 43560-2736
Ph: (419) 479-3939 |
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