Healthcare Provider Details

I. General information

NPI: 1851114268
Provider Name (Legal Business Name): FRED W. STELSON, M.D. PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 WAYMARKET DR
ANN ARBOR MI
48103-6621
US

IV. Provider business mailing address

559 WAYMARKET DR
ANN ARBOR MI
48103-6621
US

V. Phone/Fax

Practice location:
  • Phone: 734-277-2809
  • Fax:
Mailing address:
  • Phone: 734-277-2809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRED WOOLLEY STELSON
Title or Position: CEO
Credential: M.D.
Phone: 734-496-0157