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General NPI Number Information
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NPI Number | 1437224763
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Entity Type | Individual
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Provider Name | MICHAEL STEMPEK PA
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 1195 N MAIN ST
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City | PROVIDENCE
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State | RI
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Zip | 02904-1824
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Country | US
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Telephone | 401-331-8555
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Fax | 401-751-3512
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Provider Business Mailing Address
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Address Line | 1195 N MAIN ST AGAPE PRIMARY CARE
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City | PROVIDENCE
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State | RI
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Zip | 02904-1824
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Country | US
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Telephone | 401-331-8555
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Fax | 401-751-3512
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00519
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 001516
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2271
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License Number State | MA
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