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Individual

DR. STEPHAN JOHN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
11319 SOUTH SAGINAW STREET, GRAND BLANC, MI 48439-1268
(810) 694-2200
(810) 694-6750
Mailing address
11319 SOUTH SAGINAW STREET, GRAND BLANC, MI 48439-1268
(810) 694-2200
(810) 694-6750

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007830
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01006003
HEALTH PLUS
MI
01
1006672
MCLAREN HEALTH ADVA
01
P00009050
MEDICARE RAILROAD CARRIER
Enumeration date
09/29/2006
Last updated
07/08/2007
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