Provider Demographics
NPI:1043294457
Name:ASH, STEPHANIE JOANNE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JOANNE
Last Name:ASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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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
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2021-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301067456207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0983575OtherHEALTH PLUS
MI1020872OtherHEALTH ADVANTAGE
MI1020872OtherMCLAREN HEALTH PLAN
MI1600910771OtherBLUE CROSS BLUE SHIELD
MI0983575OtherHEALTH PLUS