Healthcare Provider Details

I. General information

NPI: 1033179296
Provider Name (Legal Business Name): JAMES ROBERT STENZEL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 11TH AVE
MENOMINEE MI
49858-3018
US

IV. Provider business mailing address

350 STATE ST
MARINETTE WI
54143-1224
US

V. Phone/Fax

Practice location:
  • Phone: 906-863-1286
  • Fax:
Mailing address:
  • Phone: 715-732-2703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5601002958
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: