1942795463 NPI number — ANNA STEPHANIE MCFARLAND DO

Table of content: ANNA STEPHANIE MCFARLAND DO (NPI 1942795463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942795463 NPI number — ANNA STEPHANIE MCFARLAND DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCFARLAND
Provider First Name:
ANNA
Provider Middle Name:
STEPHANIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STALA
Provider Other First Name:
ANNA
Provider Other Middle Name:
STEPHANIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942795463
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5303 S. CEDAR ST, SUITE 205
Provider Second Line Business Mailing Address:
PO BOX 30161
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-887-4305
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5303 S CEDAR ST STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48911-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-887-4305
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  5101023979 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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