Provider Demographics
NPI:1922086834
Name:POWERS, STANLYN CHRISTINE (DO)
Entity Type:Individual
Prefix:DR
First Name:STANLYN
Middle Name:CHRISTINE
Last Name:POWERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:STANLYN
Other - Middle Name:CHRISTINE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 634280
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-4280
Mailing Address - Country:US
Mailing Address - Phone:517-336-8080
Mailing Address - Fax:517-336-9122
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1811
Practice Address - Country:US
Practice Address - Phone:517-364-2223
Practice Address - Fax:517-336-9122
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI015108207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4794166Medicaid
MI200000002548OtherPHP & PHPFC
MI0153311415OtherBLUE CROSS BLUE SHIELD
MI4794166Medicaid
MI0153311415OtherBLUE CROSS BLUE SHIELD