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General NPI Number Information
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NPI Number | 1033467493
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Entity Type | Organization
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Legal Business Name | EDWARD J. STEHOUWER, M.D., P.L.L.C.
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 1675 LEAHY ST SUITE 300 - B
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City | MUSKEGON
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State | MI
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Zip | 49442-5500
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Country | US
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Telephone | 231-728-5567
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Fax | 231-725-7134
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Provider Business Mailing Address
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Address Line | 1675 LEAHY ST SUITE 300 - B
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City | MUSKEGON
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State | MI
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Zip | 49442-5500
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Country | US
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Telephone | 231-728-5567
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Fax | 231-725-7134
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD J. STEHOUWER
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Credential | M.D.
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Telephone | 231-728-5567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 38469
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License Number State | MI
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