# SEAN RAYL STEPHENSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1942219621
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 5101016669 | MI | Yes |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 04/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 114917041 | — | MI |
| 05 | — | 114917050 | — | MI |
| 05 | — | 114917097 | — | MI |