Individual
EDWARD P STACK
Active
Individual
EDWARD P STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301065179
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010198
CAPE MEDICAID
MI
01
—
028341
MIDWEST HEALTH
MI
01
—
110201
CARE CHOICES
MI
01
—
15474
SPECTERA
MA
01
—
1802511821
BCBSM
MI
01
—
4301065179
STATE LICENSE NUMBER
MI
05
—
4604520
—
MI
05
—
4774225
—
MI
01
—
5100110
AETNA
MI
01
—
6736673005
CIGNA
MI
01
—
C6993
MCARE
MI
Enumeration date
05/24/2005
Last updated
12/06/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up