Individual
STEPHANIE AUDRIANNA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
819 N SHIAWASSEE ST STE 110, OWOSSO, MI 48867-1601
(989) 723-1390
(989) 725-1415
Mailing address
819 N SHIAWASSEE ST STE 110, OWOSSO, MI 48867-1601
(989) 723-1390
(989) 725-1415
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301511940
MI
2084N0600X
Clinical Neurophysiology Physician
4301511940
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760943385
—
MI
Enumeration date
03/27/2019
Last updated
10/10/2024
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