Provider Demographics
NPI:1114129608
Name:GRIESE WILLIAMS, STEPHANIE ELAINE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ELAINE
Last Name:GRIESE WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:ELAINE
Other - Last Name:GRIESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6816 LOWELL CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1849
Mailing Address - Country:US
Mailing Address - Phone:717-773-5022
Mailing Address - Fax:
Practice Address - Street 1:751 E 36TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4166
Practice Address - Country:US
Practice Address - Phone:907-222-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101262085208000000X
MDD638212080P0204X
AK239083208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD036668400Medicaid
MD036668400Medicaid