Healthcare Provider Details

I. General information

NPI: 1225127137
Provider Name (Legal Business Name): MARK E. STEMPIHAR, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E6112 E BLUFFVIEW RD SUITE 102
IRONWOOD MI
49938-9367
US

IV. Provider business mailing address

E6112 E BLUFFVIEW RD SUITE 102
IRONWOOD MI
49938-9367
US

V. Phone/Fax

Practice location:
  • Phone: 906-932-1436
  • Fax:
Mailing address:
  • Phone: 906-932-1436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number43010042817
License Number StateMI

VIII. Authorized Official

Name: PAMELA H BRETALL
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 906-932-1436