DR. STEPHEN DALE BOVENKERK (NPI# 1760503171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760503171 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN DALE BOVENKERK |
| Credential | D.O. |
| Practice Address |
2680 S Cleveland Ave Saint Joseph MI 49085-3002 |
| Practice Telephone | 2699823368 |
| Practice Fax Number | 2699833238 |
| Mailing Telephone | 2699823368 |
| Mailing Fax Number | 2699833238 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
5101015878 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
2680 S CLEVELAND AVE |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659373256 | Dennis Fred Thompson | Otolaryngology | 2680 S Cleveland Ave, Saint Joseph, MI 49085-3002 | 2005-08-12 |
| 1184157042 | Wei Gao | Physician Assistant | 2680 S Cleveland Ave, Saint Joseph, MI 49085-3002 | 2017-04-07 |
| 1588069314 | Lakeland Medical Practices | Otolaryngology | 2680 S Cleveland Ave, Saint Joseph, MI 49085-3002 | 2014-10-22 |
| 1699945493 | Cathleen A Burns | Audiologist | 2680 S Cleveland Ave, Saint Joseph, MI 49085-3002 | 2008-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758949 | Ahmed Elshareif | Student in an Organized Health Care Education/Training Program | Lakeland Health, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2020-04-03 |
| 1033747225 | Ezra Fox | Student in an Organized Health Care Education/Training Program | Lakeland Health- Gme, 1234 Napier Avenue, St. Joseph, MI 49085 | 2020-04-01 |
| 1679033930 | Asad Butt | Student in an Organized Health Care Education/Training Program | Lakeland Health-gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2019-03-22 |
| 1184194714 | Benjamin Phillip Knuth | Physical Therapist | 3950 Hollywood Road, Suite 140, Saint Joseph, MI 49085 | 2018-11-27 |
| 1336624279 | Brandi Chatot | Counselor | 1101 Broad Street #8, Saint Joseph, MI 49085 | 2018-09-26 |
| 1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
| 1760976518 | Premier Health Associates, Inc. | Home Health | 1111 Main Sr, St Joseph, MI 49085 | 2018-06-15 |
| 1053817783 | Chantell Strong | Student in an Organized Health Care Education/Training Program | Lakeland Health - Gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2018-04-02 |
| 1386144053 | Anjana Gupta, Dds, Pllc | Dentist | 2800 Niles Road, Saint Joseph, MI 49085 | 2018-02-19 |
| 1356858997 | Hope Reborn Counseling, Pllc | Counselor | 2816 Willa Dr, Saint Joseph, MI 49085 | 2018-01-04 |
| Find all providers in zip 49085 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851720312 | Prasad J Thottam | Otolaryngology | 7001 Ochard Lake Road, 320c, West Bloomfield, MI 48322-3607 | 2013-11-05 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| 1336362722 | Danny Kewson M.d. P.c | Otolaryngology | 2454 Monroe St Ste A, Dearborn, MI 48124 | 2007-04-11 |
| 1528145935 | Demello Medical Clinic | Otolaryngology | 39379 Garfield Rd, Cilnton Township, MI 48038 | 2006-11-01 |
| 1508979436 | Russell Wayne Craig | Otolaryngology | 17901 Hall Rd, Macomb Twp, MI 48044 | 2006-08-16 |
| 1942218177 | Paul E Lomeo | Otolaryngology | 268 W Seminole Rd, Muskegon, MI 49444-3733 | 2006-08-03 |
| 1891715991 | Phillips H Winter | Otolaryngology | 577 Michigan Avenue, Suite 101, Holland, MI 49423 | 2006-07-20 |
| 1336191139 | Robert Louis Borenitsch | Otolaryngology | 5200 State St, Saginaw, MI 48603-3713 | 2006-05-17 |
| 1124007539 | Ted H Schwartzenfeld | Otolaryngology | 27483 Dequindre Rd Ste 201, Madison Heights, MI 48071-5711 | 2006-01-13 |
| 1851390066 | Michael Andrew Freedman | Otolaryngology | 14600 King Rd Ste D, Riverview, MI 48193-7952 | 2005-07-19 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 49085 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.