Healthcare Provider Details

I. General information

NPI: 1083801385
Provider Name (Legal Business Name): 7STINES PODIATRY CENTER,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SNOW RD SUITE C
LANSING MI
48917-4087
US

IV. Provider business mailing address

701 SNOW RD SUITE C
LANSING MI
48917-4087
US

V. Phone/Fax

Practice location:
  • Phone: 517-323-8333
  • Fax: 517-323-8333
Mailing address:
  • Phone: 517-323-8333
  • Fax: 517-323-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901-001340
License Number StateMI

VIII. Authorized Official

Name: DR. INGRID M STINES
Title or Position: PRESIDENT
Credential: DPM
Phone: 517-323-8333