Healthcare Provider Details

I. General information

NPI: 1346939386
Provider Name (Legal Business Name): BLESSING STEPHEN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 E. 12 MILE ROAD
WARREN MI
48093
US

IV. Provider business mailing address

11800 E. 12 MILE ROAD
WARREN MI
48093
US

V. Phone/Fax

Practice location:
  • Phone: 586-576-4157
  • Fax: 586-573-5855
Mailing address:
  • Phone: 586-576-4157
  • Fax: 586-573-5855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101290263
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: