Healthcare Provider Details

I. General information

NPI: 1871805002
Provider Name (Legal Business Name): STEPHANIE SALINAS GALLAGHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE LOUISE SALINAS M.D.

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16001 W 9 MILE RD
SOUTHFIELD MI
48075-4818
US

IV. Provider business mailing address

16001 W 9 MILE RD
SOUTHFIELD MI
48075-4818
US

V. Phone/Fax

Practice location:
  • Phone: 248-849-3046
  • Fax: 248-849-8339
Mailing address:
  • Phone: 248-849-3046
  • Fax: 248-849-8339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301096902
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number4301096902
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: