Provider Demographics
NPI:1134233992
Name:LING-STOWERS, ENID ATHENA (MD)
Entity type:Individual
Prefix:
First Name:ENID
Middle Name:ATHENA
Last Name:LING-STOWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ENID
Other - Middle Name:A
Other - Last Name:LING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:275 MICHIGAN ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2531
Practice Address - Country:US
Practice Address - Phone:616-391-5272
Practice Address - Fax:616-391-9010
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301511835207PE0005X, 207P00000X, 207PE0005X
TXS5970207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine