Provider Demographics
NPI:1508875949
Name:STIFFLER, DON MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:MICHAEL
Last Name:STIFFLER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:804 SERVICE RD
Mailing Address - Street 2:A201
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:1200 E MICHIGAN AVE
Practice Address - Street 2:SUITE 145
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1800
Practice Address - Country:US
Practice Address - Phone:517-364-5440
Practice Address - Fax:517-363-5409
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-06-07
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Provider Licenses
StateLicense IDTaxonomies
MI301046358208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1508875949Medicaid
MIC36092066Medicare PIN
MI1508875949Medicaid