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General NPI Number Information
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NPI Number | 1588835433
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Entity Type | Organization
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Legal Business Name | GREGORY E STEPHENS DO PC
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 18174 MERIDIAN RD
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City | GROSSE ILE
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State | MI
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Zip | 48138-1088
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Country | US
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Telephone | 313-282-5824
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Fax |
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Provider Business Mailing Address
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Address Line | 14600 KING RD SUITE D
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City | RIVERVIEW
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State | MI
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Zip | 48193-7952
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Country | US
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Telephone | 734-479-7310
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GREGORY E STEPHENS
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Credential | D.O.
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Telephone | 734-479-7310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5101010374
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License Number State | MI
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