Provider Demographics
NPI:1780652552
Name:SOKOLOWSKI, STEPHEN CHESTER (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CHESTER
Last Name:SOKOLOWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3058 METRO PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-3671
Mailing Address - Country:US
Mailing Address - Phone:586-939-8875
Mailing Address - Fax:586-939-8870
Practice Address - Street 1:3058 METRO PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-3671
Practice Address - Country:US
Practice Address - Phone:586-939-8875
Practice Address - Fax:586-939-8870
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE30927Medicare UPIN
5501895Medicare ID - Type Unspecified