Individual
DR. DANIEL A STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3950 HOLLYWOOD RD, SUITE 100, SAINT JOSEPH, MI 49085-9151
(269) 429-0900
(269) 408-0996
Mailing address
3950 HOLLYWOOD ROAD, SUITE 100, ST JOSEPH, MI 49085
(269) 429-0900
(269) 408-0996
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301404254
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201109862
BLUE CROSS PIN
MI
01
—
1538397120
GROUP NPI
MI
05
—
1831127463
—
MI
01
—
27-0381199
GROUP TAX ID
MI
01
—
MI2051
GROUP MEDICARE PTAN
MI
Enumeration date
06/30/2006
Last updated
03/07/2023
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