Provider Demographics
NPI:1801824164
Name:STUBBLEFIELD, MICHAEL STERLING (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STERLING
Last Name:STUBBLEFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6089 N. FIRST ST #104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5464
Mailing Address - Country:US
Mailing Address - Phone:559-439-3300
Mailing Address - Fax:559-439-2707
Practice Address - Street 1:6089 N. FIRST ST #104
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5464
Practice Address - Country:US
Practice Address - Phone:559-439-3300
Practice Address - Fax:559-439-2707
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA34392Medicare UPIN