Individual
DR. JENNIFER STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
(586) 236-2601
Mailing address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3354
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101014444
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11-4585200
—
MI
05
—
11-4831546
—
MI
05
—
11-4831555
—
MI
05
—
11-4831564
—
MI
05
—
11-4831582
—
MI
05
—
11-4831591
—
MI
01
—
11289723
CAQH
—
Enumeration date
01/09/2006
Last updated
06/06/2013
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