Individual
DR. GREGORY E STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
18174 MERIDIAN RD, GROSSE ILE, MI 48138-1088
(313) 282-5824
(000) 000-0000
Mailing address
18174 MERIDIAN RD, GROSSE ILE, MI 48138-1088
(313) 282-5824
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
5101010374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158223820
BLUE CROSS MICHIGAN
MI
05
—
3086232
—
MI
01
—
383461449
FEDERAL TAX ID
MI
01
—
C5211
MCARE
MI
01
—
P85024
BLUE CARE NETWORK
MI
Enumeration date
08/19/2005
Last updated
12/20/2024
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