Wilson, Stephen
Wilson, Stephen is an individual health care provider with primary practice located at 24345 Harper Ave , St Clair Shores MI 48080. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Wilson, Stephen can be contacted via phone (586) 563-3300.Contact Information
Primary practice address
24345 Harper Ave
St Clair Shores MI 48080
Phone: (586) 563-3300
Fax: (586) 563-3313
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | SW061846 | Michigan |
Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | SW061846 | Michigan |
Profile Details
NPI number | 1659376267 |
---|---|
LBN Legal business name | Wilson, Stephen |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 20th, 2005 |
Last updated | Jul 23rd, 2008 - about 17 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 | 1659376267 | NPPES |
Michigan | MEDICAID | 4332250 | |
Michigan | Other | 5614160001 | |
Michigan | Other | 2505012031 | |
Michigan | MEDICAID | 4332250 10 | |
Michigan | Other | 1932129319 | |
Michigan | Other | 540E019050 |
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