| Stephen Prefontaine, Do, Plc | |
|
4081 Cascade Rd Se Suite A Grand Rapids MI 49546-2170 | |
| (616) 336-7662 | |
| (616) 336-7682 |
| Full Name | Stephen Prefontaine, Do, Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 4081 Cascade Rd Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Stephen Prefontaine (OWNER) |
| Authorized Official Contact | 6163367662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen Prefontaine, Do, Plc 4081 Cascade Rd Se Suite A Grand Rapids MI 49546-2170 Ph: (616) 336-7662 | Stephen Prefontaine, Do, Plc 4081 Cascade Rd Se Suite A Grand Rapids MI 49546-2170 Ph: (616) 336-7662 |
| NPI Number | 1124274006 |
|---|---|
| Provider Enumeration Date | 08/12/2008 |
| Last Update Date | 08/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124274006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101011668 (Michigan) | Primary |
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