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General NPI Number Information
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NPI Number | 1932330818
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Entity Type | Individual
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Provider Name | STEPHANIE NICOLE WUEST MD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 1500 SANDPOINT RD
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City | MUNISING
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State | MI
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Zip | 49862-1406
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Country | US
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Telephone | 906-387-4338
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Fax | 906-387-2825
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Provider Business Mailing Address
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Address Line | 1500 SANDPOINT RD
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City | MUNISING
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State | MI
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Zip | 49862-1406
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Country | US
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Telephone | 906-387-4338
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Fax | 906-387-2825
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301102361
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01073957A
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License Number State | IN
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