{
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"IsOrgSubpart": "N",
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"OrgName": "L MICHAEL STERENBERG DO PLLC",
"LastName": null,
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"NamePrefix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "600 PARK AVE STE 4",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND HAVEN",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49417-2173",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "616-847-8700",
"MailingAddressFaxNumber": "616-847-1049",
"FirstLinePracticeLocationAddress": "600 PARK AVE",
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"PracticeLocationAddressCityName": "GRAND HAVEN",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "616-847-8700",
"PracticeLocationAddressFaxNumber": "616-847-1049",
"EnumerationDate": "07/28/2007",
"LastUpdateDate": "09/16/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STERENBERG",
"AuthorizedOfficialFirstName": "LEE",
"AuthorizedOfficialMiddleName": "MICHAEL",
"AuthorizedOfficialTitle": "PHYSICIAN/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D O",
"AuthorizedOfficialTelephoneNumber": "616-847-8700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "5101009998",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}