MEDICARE: MICHAEL STIERMAN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	COA.10338-NP	OH
2	363LF0000X	Family Nurse Practitioner	COA10338-NP	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194977900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL STIERMAN NP

Provider Business Mailing Address
First Line	:	12780 ROACHTON RD # 1
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-1350
Country	:	US
Telephone Number	:	419-872-0777
Fax Number	:	419-872-2369

Provider Business Practice Location Address
First Line	:	12780 ROACHTON RD # 1
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-1350
Country	:	US
Telephone Number	:	419-872-0777
Fax Number	:	419-872-2369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2008
Last Update Date	:	08/07/2012

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