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Individual

STEPHANIE ANN GARSTECK-POLAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
44201 DEQUINDRE RD, ATTN SURGICAL SERVICES, TROY, MI 48085-1117
(248) 964-3012
(248) 964-3012
Mailing address
44201 DEQUINDRE RD, ATTN SURGICAL SERVICES, TROY, MI 48085-1117
(248) 964-3012
(248) 964-3012

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704153624
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3227635
MI
01
430042552
TRAVELERS MEDICARE
MI
01
SG153624
BLUE SHIELD
MI
Enumeration date
02/09/2006
Last updated
02/27/2014
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