Provider Demographics
NPI:1235104845
Name:HIGGINS, STEPHEN E (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:E
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3142 W CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-4860
Mailing Address - Country:US
Mailing Address - Phone:269-329-5870
Mailing Address - Fax:269-329-5865
Practice Address - Street 1:3142 W CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-4860
Practice Address - Country:US
Practice Address - Phone:269-329-5870
Practice Address - Fax:269-329-5865
Is Sole Proprietor?:No
Enumeration Date:2006-02-18
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301405954207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2669516Medicaid
MI2669516Medicaid