Individual
BENJAMIN STAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 364-4200
Mailing address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4280
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301107051
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
06/05/2015
Last updated
07/08/2019
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