Individual
SEAN RAYL STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
305 N LEROY ST, FENTON, MI 48430-2729
(810) 629-0336
(810) 629-7251
Mailing address
305 N LEROY ST, FENTON, MI 48430-2729
(810) 629-0336
(810) 629-7251
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101016669
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114917041
—
MI
05
—
114917050
—
MI
05
—
114917097
—
MI
Enumeration date
08/05/2006
Last updated
04/30/2008
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