Healthcare Provider Details

I. General information

NPI: 1881634343
Provider Name (Legal Business Name): STEPHEN ALEXANDER LERNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HARPER HOSPITAL 5 HUDSON 3990 JOHN R
DETROIT MI
48201
US

IV. Provider business mailing address

1560 E MAPLE RD SUITE 400 - CREDENTIALING
TROY MI
48083-1138
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-7105
  • Fax: 313-993-0302
Mailing address:
  • Phone: 313-745-7105
  • Fax: 313-993-0302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301049916
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: