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General NPI Number Information
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NPI Number | 1891613584
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Entity Type | Organization
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Legal Business Name | MICHIGAN INSTITUTE OF PUBLIC HEALTH
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 3925 FORTUNE BLVD
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City | SAGINAW
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State | MI
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Zip | 48603-2287
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Country | US
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Telephone | 989-341-5078
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Fax |
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Provider Business Mailing Address
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Address Line | 3925 FORTUNE BLVD
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City | SAGINAW
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State | MI
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Zip | 48603-2287
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Country | US
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Telephone | 989-341-5078
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID STOCKMAN
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Credential | MD
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Telephone | 989-341-5078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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