Healthcare Provider Details

I. General information

NPI: 1114939931
Provider Name (Legal Business Name): STEVEN POPPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 E EISENHOWER PKWY SUITE 100
ANN ARBOR MI
48108-5205
US

IV. Provider business mailing address

2100 COMMONWEALTH BLVD SUITE 202
ANN ARBOR MI
48105-1593
US

V. Phone/Fax

Practice location:
  • Phone: 734-971-9344
  • Fax: 734-971-2303
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number43010525271
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: