Healthcare Provider Details

I. General information

NPI: 1386552404
Provider Name (Legal Business Name): STILLWATER MIND AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 FAYETTEVILLE ST STE 300
RALEIGH NC
27601-3066
US

IV. Provider business mailing address

2301 S HURON PKWY STE 2B
ANN ARBOR MI
48104-5133
US

V. Phone/Fax

Practice location:
  • Phone: 734-796-5552
  • Fax: 734-480-8686
Mailing address:
  • Phone: 734-796-5552
  • Fax: 734-480-8686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MERIAM SAM
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: NP
Phone: 734-796-5552