Provider Demographics
NPI:1811981491
Name:STAMBERGER, SETH (MD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:
Last Name:STAMBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3145 W CLARK RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1120
Mailing Address - Country:US
Mailing Address - Phone:734-528-5790
Mailing Address - Fax:734-528-5744
Practice Address - Street 1:3145 W CLARK RD
Practice Address - Street 2:SUITE 401
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1120
Practice Address - Country:US
Practice Address - Phone:734-528-5700
Practice Address - Fax:734-528-5703
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2007-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301082696207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I42316Medicare UPIN