Provider Demographics
NPI:1306036090
Name:L MICHAEL STERENBERG DO PLLC
Entity Type:Organization
Organization Name:L MICHAEL STERENBERG DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STERENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:D O
Authorized Official - Phone:616-847-8700
Mailing Address - Street 1:600 PARK AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2173
Mailing Address - Country:US
Mailing Address - Phone:616-847-8700
Mailing Address - Fax:616-847-1049
Practice Address - Street 1:600 PARK AVE
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2173
Practice Address - Country:US
Practice Address - Phone:616-847-8700
Practice Address - Fax:616-847-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-28
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty