Provider Demographics
NPI:1588988422
Name:STEPHEN J GUNTHER M D P L C
Entity type:Organization
Organization Name:STEPHEN J GUNTHER M D P L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:GUNTHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-594-4913
Mailing Address - Street 1:31500 TELEGRAPH RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4367
Mailing Address - Country:US
Mailing Address - Phone:248-594-4913
Mailing Address - Fax:248-594-4928
Practice Address - Street 1:31500 TELEGRAPH RD
Practice Address - Street 2:SUITE 115
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4367
Practice Address - Country:US
Practice Address - Phone:248-594-4913
Practice Address - Fax:248-594-4928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B47881Medicare UPIN
0M67960Medicare PIN