Individual
DR. STEPHANIE SOMERS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5082 LOVERS LN, PORTAGE, MI 49002-1557
(269) 381-0118
(269) 381-4610
Mailing address
5082 LOVERS LN, PORTAGE, MI 49002-1557
(269) 381-0118
(269) 381-4610
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301070332
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1231911
PHP
MI
05
—
3378353
—
MI
01
—
3503903762
BLUE CROSS PIN
MI
01
—
4301070332
STATE LICENSE
MI
01
—
P61269
BLUE CHOICE
MI
Enumeration date
01/13/2006
Last updated
03/07/2023
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