Provider Demographics
NPI:1346316023
Name:LANDAU, STEPHEN GERALD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GERALD
Last Name:LANDAU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:37727 PROFESSIONAL CENTER DR
Mailing Address - Street 2:SUITE 115 D
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1195
Mailing Address - Country:US
Mailing Address - Phone:734-953-0405
Mailing Address - Fax:734-953-9747
Practice Address - Street 1:37727 PROFESSIONAL CENTER DR
Practice Address - Street 2:SUITE 115 D
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1195
Practice Address - Country:US
Practice Address - Phone:734-953-0405
Practice Address - Fax:734-953-9747
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010282652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID99730Medicare UPIN