Individual
DR. JERRY STASSINOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, 6-UHC, DETROIT, MI 48201-2153
(313) 577-5009
Mailing address
24908 REEDS POINTE DR, NOVI, MI 48374-2540
(248) 349-6658
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301084022
MI
208600000X
Surgery Physician
DR.0062274
CO
Other
Enumeration date
05/17/2007
Last updated
06/24/2019
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