Peck, Stephen L
Peck, Stephen L is an individual health care provider with primary practice located at 1717 Shaffer St Suite 232, Kalamazoo MI 49048-1647. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Peck, Stephen L can be contacted via phone (269) 226-5050.Contact Information
Primary practice address
1717 Shaffer St Suite 232
Kalamazoo MI 49048-1647
Phone: (269) 226-5050
Fax: (269) 226-5034
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 4301038298 | Michigan |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 4301038298 | Michigan |
Profile Details
| NPI number | 1124127162 |
|---|---|
| LBN Legal business name | Peck, Stephen L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jun 11th, 2015 - about 10 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 | 1124127162 | NPPES |
| Michigan | Other | 25-31067 | PHP/IBA |
| Michigan | Other | SP038298 | PHP/IBA |
| Michigan | Other | P54643 | PHP/IBA |
| Michigan | MEDICAID | 1394115 | PHP/IBA |
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