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Individual

STACEY ANN SHUBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3535 W 13 MILE RD STE LL, ROYAL OAK, MI 48073-6770
(248) 551-3000
(248) 423-2576
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301069890
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350F36132
BCBSM
MI
05
4275628
MI
Enumeration date
08/10/2006
Last updated
10/22/2020
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