Healthcare Provider Details

I. General information

NPI: 1396905881
Provider Name (Legal Business Name): STEPHANIE BARBERA GALDES D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5024 N ROYAL DR
TRAVERSE CITY MI
49684-9230
US

IV. Provider business mailing address

5024 N ROYAL DR
TRAVERSE CITY MI
49684-9230
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-0555
  • Fax: 231-935-0562
Mailing address:
  • Phone: 231-935-0555
  • Fax: 231-935-0562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101017771
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: