Stacy Suzanne Bull in East Lansing - Sports Medicine
Stacy Suzanne Bull - NPI 1619071115
Stacy Suzanne Bull is a Sports Medicine in East Lansing, Michigan. Stacy Suzanne Bull practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Stacy Suzanne Bull is 1619071115. The last update date is 2018-09-07.
Stacy Suzanne Bull's current location address is 463 E Circle Dr, East Lansing, Michigan. You can contact this provider via phone number 5178846502 and fax number 5173559265. The mailing address for Stacy Suzanne Bull is 463 E Circle Dr, East Lansing, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stacy Suzanne Bull |
|---|---|
| Address | 463 E Circle Dr, East Lansing, Michigan |
| Phone Number | 5178846502 |
| Fax Number | 5173559265 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1619071115 |
|---|---|
| Provider Enumeration Date | 2006-09-13 |
| Last Updated Date | 2018-09-07 |
Provider Mailing Address Detail
| Address | 463 E Circle Dr |
|---|---|
| City | East Lansing |
| State | Michigan (MI) |
| Post Code | 488247500 |
| Phone Number | 5178846502 |
| Fax Number | 5173559265 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Qs0010X |
| Licence No | 4301070974 |
|
Definition: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4546883 | MI | -- | |
| 803310501 | MI | BCBS INDIVIDUAL PIN | |
| 1619071115 | MI | -- |
Post Comment/ Review Below
What is the Stacy Suzanne Bull's 1619071115?
The Stacy Suzanne Bull's NPI (National Provider Identifier) Number is 1619071115. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Stacy Suzanne Bull is geographically located?
The Stacy Suzanne Bull is physically situated at the following location: 463 E Circle Dr, East Lansing, MI, 488247500.
What is Stacy Suzanne Bull's specialized field of practice, and what is the corresponding taxonomy classification code?
The Stacy Suzanne Bull's area of specialization is Sports Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Qs0010X.
When did the Stacy Suzanne Bull receive its 1619071115?
The Stacy Suzanne Bull was issued its 1619071115 on 2006-09-13, which is the date when the organization was assigned this unique identifier.
When was the information regarding Stacy Suzanne Bull most recently updated?
The details pertaining to the Stacy Suzanne Bull, including its address, specialty, and other relevant information, were last refreshed on 2018-09-07.