Provider Demographics
NPI:1699946822
Name:STONE, STEPHEN SAMSON (OD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SAMSON
Last Name:STONE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23660 INDUSTRIAL PARK DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2838
Mailing Address - Country:US
Mailing Address - Phone:248-478-0320
Mailing Address - Fax:
Practice Address - Street 1:23660 INDUSTRIAL PARK DR
Practice Address - Street 2:SUITE 111
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2838
Practice Address - Country:US
Practice Address - Phone:248-478-0320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-15
Last Update Date:2008-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002410152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management