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Individual

BARBARA E STANFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
300 LAFAYETTE SE, STE 4200, GRAND RAPIDS, MI 49503
(616) 685-6922
(616) 685-5105
Mailing address
245 STATE ST SE, STE 228, GRAND RAPIDS, MI 49503
(616) 685-1808
(616) 685-1850

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301068515
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4203843
MI
05
4289098
MI
05
4394084
MI
05
4810804
MI
05
4877250
MI
05
4877760
MI
Enumeration date
07/14/2006
Last updated
06/21/2011
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