Individual
DR. EVAN M. STASHEFSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27483 DEQUINDRE RD, SUITE 302, MADISON HEIGHTS, MI 48071-3491
(248) 547-6603
(248) 547-5696
Mailing address
29992 NORTHWESTERN HWY STE C, FARMINGTON HILLS, MI 48334-3292
(248) 851-1430
(248) 851-5182
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301082957
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699828632
—
MI
01
—
MI4989151
MEDICARE PTAN
MI
Enumeration date
01/22/2007
Last updated
11/25/2019
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