Individual
STEPHEN PAVLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2565 N HUMMINGBIRD PASS, MIDLAND, MI 48642-7892
(989) 835-5413
Mailing address
2565 N HUMMINGBIRD PASS, MIDLAND, MI 48642-7892
(989) 835-5413
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
340654
NY
2085R0202X
Diagnostic Radiology Physician
83257
CT
2085R0202X
Diagnostic Radiology Physician
Primary
SP057702
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124048160
—
MI
01
—
300E676040
BLUE CROSS
MA
Enumeration date
07/20/2006
Last updated
11/11/2025
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