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General NPI Number Information
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NPI Number | 1881892388
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE-COHEN BRAY M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 4660 S HAGADORN RD STE 600
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City | EAST LANSING
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State | MI
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Zip | 48823-5383
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Country | US
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Telephone | 517-267-2460
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Fax | 517-884-8602
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Provider Business Mailing Address
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Address Line | 4660 SOUTH HAGADORN ROAD SUITE #600
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City | EAST LANSING
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State | MI
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Zip | 48823
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Country | US
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Telephone | 517-884-2976
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Fax | 517-432-3928
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 4301113538
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301113538
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 4301113538
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License Number State | MI
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