# GREAT LAKES SLEEP MEDICINE INSTITUTE PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295906741
- **Authorized official:** DR. YEVGENIY STEFADU MD (OWNER)
- **Authorized official phone:** (586) 268-0100

## Contact information

- **Practice address:** 3058 METROPOLITAN PARKWAY, SUITE 108, STERLING HEIGHTS, MI 48310
- **Practice address phone:** (586) 268-0100
- **Practice address fax:** (586) 268-5818
- **Mailing address:** 5215 CROWFOOT, C O Y STEFADU MD, TROY, MI 48310
- **Mailing address phone:** (586) 268-0100
- **Mailing address fax:** (586) 268-5818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/12/2008
- **Last updated:** 03/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | OP22380 | MEDICARE STUDY | — |