Miller, Stacey Lynne
Miller, Stacey Lynne is an individual health care provider with primary practice located at 44250 Garfield Rd Ste 160, Clinton Township MI 48038-1150. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Miller, Stacey Lynne can be contacted via phone (586) 228-2255.Contact Information
Primary practice address
44250 Garfield Rd Ste 160
Clinton Township MI 48038-1150
Phone: (586) 228-2255
Fax: (586) 228-2740
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | SM001761 | Michigan |
Profile Details
| NPI number | 1710982434 |
|---|---|
| LBN Legal business name | Miller, Stacey Lynne |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Oct 22nd, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710982434 | NPPES |
| Michigan | Other | 104531 | GREAT LAKES HEALTH PLAN |
| Michigan | MEDICAID | 4616763 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | 4855050800 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | 4855050800 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | 9102424001 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | U71952 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | 10113130003 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | 4616763 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | 17303 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | 7538001 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | 126745 | GREAT LAKES HEALTH PLAN |
| Michigan | Other | P00140080 | GREAT LAKES HEALTH PLAN |
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