Stack, Edward P

Stack, Edward P is an individual health care provider with primary practice located at 5300 Gateway Ctr , Flint MI 48507-3930. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Stack, Edward P can be contacted via phone (810) 720-9111.

Contact Information

Primary practice address
5300 Gateway Ctr Flint MI 48507-3930
Phone: (810) 720-9111
Fax: (810) 720-9119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 4301065179 Michigan

Profile Details

NPI number 1801899885
LBN Legal business name Stack, Edward P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Dec 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801899885 NPPES
Massachusetts Other 15474 SPECTERA
Massachusetts Other 5100110 SPECTERA
Massachusetts MEDICAID 4774225 SPECTERA
Massachusetts Other C6993 SPECTERA
Massachusetts Other 6736673005 SPECTERA
Massachusetts Other 110201 SPECTERA
Massachusetts Other 1802511821 SPECTERA
Massachusetts Other 4301065179 SPECTERA
Massachusetts Other 000000010198 SPECTERA
Massachusetts Other 028341 SPECTERA
Massachusetts MEDICAID 4604520 SPECTERA

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