Etengoff, Stuart

Etengoff, Stuart is an individual health care provider with primary practice located at 1 Genesys Pkwy , Grand Blanc MI 48439-8065. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Etengoff, Stuart can be contacted via phone (810) 606-6137.

Contact Information

Primary practice address
1 Genesys Pkwy Grand Blanc MI 48439-8065
Phone: (810) 606-6137
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 5101009547 Michigan
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 5101009547 Michigan

Profile Details

NPI number 1326021213
LBN Legal business name Etengoff, Stuart
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Mar 6th, 2008 - about 16 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 1326021213 NPPES
Michigan MEDICAID 3483706
Michigan MEDICAID 3483804
Michigan MEDICAID 3095035
Michigan Other SE009547
Michigan Other P00113859

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