Healthcare Provider Details

I. General information

NPI: 1720436397
Provider Name (Legal Business Name): ALLISON A STOECKER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2433 OAK VALLEY DR STE 400
ANN ARBOR MI
48103-7602
US

IV. Provider business mailing address

5141 VIRGINIA WAY STE 350
BRENTWOOD TN
37027-2319
US

V. Phone/Fax

Practice location:
  • Phone: 734-477-0200
  • Fax:
Mailing address:
  • Phone: 855-744-8554
  • Fax: 630-495-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberDO184772
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberDO184772
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number5101026056
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: