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Individual

GARY D. STEBELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2750 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-8614
(616) 447-5870
(616) 391-7733
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301407210
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0984252
HEALTHPLUS COMMERCIAL
MI
01
1004341
MCLAREN HEALTH PLAN
MI
01
1102900551
BCBSM
MI
01
200000005890
PHP COMMERCIAL
MI
05
3414128-10
MI
Enumeration date
07/03/2006
Last updated
07/21/2014
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