Provider Demographics
NPI:1972617835
Name:STEPHANIE J ASH MD PLLC
Entity Type:Organization
Organization Name:STEPHANIE J ASH MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-895-6484
Mailing Address - Street 1:829 N. PINE RD.
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-2109
Mailing Address - Country:US
Mailing Address - Phone:989-895-6484
Mailing Address - Fax:989-895-2520
Practice Address - Street 1:829 N. PINE RD.
Practice Address - Street 2:
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732
Practice Address - Country:US
Practice Address - Phone:989-895-6484
Practice Address - Fax:989-895-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301067456207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0091077OtherBCBS MI
MI0091077OtherBCBS MI
MI0P35980Medicare PIN