Provider Demographics
NPI:1134114754
Name:BACHMEYER, STEPHEN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAMES
Last Name:BACHMEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E CUMMINS ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-2070
Mailing Address - Country:US
Mailing Address - Phone:517-423-2960
Mailing Address - Fax:517-423-2786
Practice Address - Street 1:501 E CUMMINS ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-2070
Practice Address - Country:US
Practice Address - Phone:517-423-2960
Practice Address - Fax:517-423-2786
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3467696Medicaid
G75702Medicare UPIN
MIOM50540004Medicare ID - Type Unspecified