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Individual

STEPHEN D DEFRIEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
501 S BALLENGER HWY, SUITE B, FLINT, MI 48532-3641
(810) 342-4800
Mailing address
501 S BALLENGER HWY, SUITE B, FLINT, MI 48532-3641
(810) 342-4800

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0102207752
VA
2085R0202X
Diagnostic Radiology Physician
Primary
5101014531
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
300B560780
BCBS
MI
05
4767650
MI
Enumeration date
06/12/2006
Last updated
08/08/2023
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