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General NPI Number Information
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NPI Number | 1114805405
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Entity Type | Individual
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Provider Name | ALLYSON L STEFANIDES
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Gender |
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 38800 GARFIELD RD STE 100
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-6619
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Country | US
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Telephone | 586-231-0306
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Fax | 586-231-0307
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Provider Business Mailing Address
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Address Line | 19227 FLORIDA ST
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City | ROSEVILLE
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State | MI
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Zip | 48066-4166
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Country | US
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Telephone | 586-345-7196
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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