Bull, Stacy Suzanne

Bull, Stacy Suzanne is an individual health care provider with primary practice located at 463 E Circle Dr , East Lansing MI 48824-7500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Bull, Stacy Suzanne can be contacted via phone (517) 884-6502.

Contact Information

Primary practice address
463 E Circle Dr East Lansing MI 48824-7500
Phone: (517) 884-6502
Fax: (517) 355-9265
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 4301070974 Michigan

Profile Details

NPI number 1619071115
LBN Legal business name Bull, Stacy Suzanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Sep 7th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619071115 NPPES
Michigan MEDICAID 4546883
Michigan Other 0803310501
Michigan MEDICAID 1619071115

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