Individual
MARK E STANIFORTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1250 MERCY DR, STE 101, MUSKEGON, MI 49444-1881
(231) 739-6375
Mailing address
1250 MERCY DR, STE 101, MUSKEGON, MI 49444-1881
(231) 733-1912
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
5315016730
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4625118
—
MI
Enumeration date
08/10/2005
Last updated
08/23/2017
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