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General NPI Number Information
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NPI Number | 1679649768
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Entity Type | Individual
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Provider Name | EDWARD JOHN STEHOUWER MD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 1675 LEAHY STREET SUITE 300
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City | MUSKEGON
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State | MI
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Zip | 49442-5543
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Country | US
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Telephone | 231-728-5567
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Fax | 231-725-7134
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Provider Business Mailing Address
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Address Line | 1675 LEAHY STREET SUITE 300
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City | MUSKEGON
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State | MI
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Zip | 49442-5543
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Country | US
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Telephone | 231-728-5567
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Fax | 231-725-7134
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 38469
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License Number State | MI
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