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General NPI Number Information
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NPI Number | 1043785959
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Entity Type | Individual
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Provider Name | STEPHANIE ANDREA HELMINIAK PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/06/2018
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Last Update Date | 10/06/2018
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Provider Practice Location Address
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Address Line | 2915 WALTON BLVD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-1419
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Country | US
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Telephone | 248-759-4222
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Fax |
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Provider Business Mailing Address
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Address Line | 19608 GAUKLER ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-3352
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Country | US
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Telephone | 586-879-8165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601008862
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License Number State | MI
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