Individual
STEPHEN ROBERT TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPAS, PA-C
Contact information
Practice address
2865 N REYNOLDS RD BLDG A, TOLEDO, OH 43615-2100
(419) 578-7200
(419) 537-5600
Mailing address
16925 WATERLOO RD, CHELSEA, MI 48118-9021
(734) 368-7025
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.008487RX
OH
363A00000X
Physician Assistant
5601008212
MI
Other
Enumeration date
05/22/2017
Last updated
11/21/2023
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