Healthcare Provider Details

I. General information

NPI: 1962631309
Provider Name (Legal Business Name): STACY MAJORAS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACY SCHEIBELHUT DO

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 11/27/2023
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 TURWILL LN
KALAMAZOO MI
49006-4231
US

IV. Provider business mailing address

315 TURWILL LN
KALAMAZOO MI
49006-4231
US

V. Phone/Fax

Practice location:
  • Phone: 269-343-8170
  • Fax: 269-382-2388
Mailing address:
  • Phone: 269-343-8170
  • Fax: 269-382-2388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number34.010682
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number5101022138
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.010682
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: