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General NPI Number Information
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NPI Number | 1992795181
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Entity Type | Individual
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Provider Name | STEFAN NEDELEA P.T.
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Gender | Male
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 36880 WOODWARD AVE SUITE 104
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-0919
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Country | US
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Telephone | 248-593-8677
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Fax | 248-593-8683
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Provider Business Mailing Address
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Address Line | 36880 WOODWARD AVE SUITE 104
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-0919
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Country | US
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Telephone | 248-593-8677
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Fax | 248-593-8683
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | SN008896
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License Number State | MI
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