Healthcare Provider Details

I. General information

NPI: 1033188164
Provider Name (Legal Business Name): ROBERT STANKEWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 COBB ST
CADILLAC MI
49601-2588
US

IV. Provider business mailing address

608 HOLLY RD
CADILLAC MI
49601-2420
US

V. Phone/Fax

Practice location:
  • Phone: 231-775-6521
  • Fax: 231-775-1366
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301067937
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: