Individual
STEPHANIE C WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5515 CLEVELAND AVE, STEVENSVILLE, MI 49127-9670
(269) 429-6604
(269) 429-1715
Mailing address
5515 CLEVELAND AVE, SUITE 2, STEVENSVILLE, MI 49127-9670
(269) 439-6604
(269) 429-1715
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
56101006545
MI
363AM0700X
Medical Physician Assistant
Primary
5601006545
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134464167
—
MI
Enumeration date
12/03/2012
Last updated
09/04/2015
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