Provider Demographics
NPI:1205366572
Name:ABUL, STEPHANIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN
Last Name:ABUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:DUPERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4345 WINTERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-8672
Mailing Address - Country:US
Mailing Address - Phone:989-996-3269
Mailing Address - Fax:
Practice Address - Street 1:33875 KIELY DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-3604
Practice Address - Country:US
Practice Address - Phone:586-725-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301500798207N00000X, 2083B0002X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine