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General NPI Number Information
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NPI Number | 1386552404
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Entity Type | Organization
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Legal Business Name | STILLWATER MIND AND WELLNESS PLLC
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 555 FAYETTEVILLE ST STE 300
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City | RALEIGH
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State | NC
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Zip | 27601-3066
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Country | US
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Telephone | 734-796-5552
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Fax | 734-480-8686
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Provider Business Mailing Address
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Address Line | 2301 S HURON PKWY STE 2B
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City | ANN ARBOR
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State | MI
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Zip | 48104-5133
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Country | US
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Telephone | 734-796-5552
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Fax | 734-480-8686
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | MRS. MERIAM SAM
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Credential | NP
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Telephone | 734-796-5552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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