Healthcare Provider Details

I. General information

NPI: 1962992990
Provider Name (Legal Business Name): MICHELLE FAYE STEPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N TELEGRAPH RD
PONTIAC MI
48341-1032
US

IV. Provider business mailing address

6086 BARNES RD
BROWN CITY MI
48416-9030
US

V. Phone/Fax

Practice location:
  • Phone: 248-451-3741
  • Fax:
Mailing address:
  • Phone: 810-728-6283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number3201008424
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: