Individual
KENNETH E STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
830 W LAKE LANSING RD, SUITE 190, EAST LANSING, MI 48823-6371
(517) 333-3777
(517) 203-3956
Mailing address
830 W LAKE LANSING RD, SUITE 190, EAST LANSING, MI 48823-6371
(517) 333-3777
(517) 203-3956
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
5101010508
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0970031
PHP-FAMILY CARE
MI
01
—
1017937
MCLAREN HEALTH ADVANTAGE
MI
01
—
200000001155
PHYSICIANS HEALTH PLAN
MI
01
—
200C313650
BLUECARE NETWORK
MI
01
—
300040412
TRICARE
MI
05
—
4838574
—
MI
Enumeration date
02/22/2006
Last updated
10/09/2014
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