Basic Information
| Provider Information | |||||||||
| NPI: | 1831518406 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HUNT | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | MATTHEW | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7391 W CHARLESTON BLVD STE 140 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891171577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028234255 | ||||||||
| FaxNumber: | 7028233625 | ||||||||
| Practice Location | |||||||||
| Address1: | 325 9TH AVE | ||||||||
| Address2: | HMC 3.EC.27, BOX 359702 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067448334 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2014 | ||||||||
| LastUpdateDate: | 07/01/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 17841 | NV | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1831518406 | 05 | AZ | MEDICAID | 1831518406 | 05 | CA | MEDICAID | 1831518406 | 05 | NV | MEDICAID | 3009807 | 05 | UT | MEDICAID |