Healthcare Provider Details

I. General information

NPI: 1396946380
Provider Name (Legal Business Name): ANGELA DAWN STOIAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA BURGETT

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E MOUNT HOPE AVE
LANSING MI
48910-3207
US

IV. Provider business mailing address

3127 FOREST RD APT 101
LANSING MI
48910-3851
US

V. Phone/Fax

Practice location:
  • Phone: 517-372-9175
  • Fax:
Mailing address:
  • Phone: 517-862-0978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101016114
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: