Stephen Prefontaine, DO, PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101011668 Issued in MI

Legal business name

STEPHEN PREFONTAINE, DO, PLC

Practice address

4081 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-2170

Phone

(616) 336-7662

Fax

(616) 336-7682

NPI assigned

Aug 12, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen Prefontaine, DO

Title

Owner

Phone

(616) 336-7662

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1124274006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4081 CASCADE RD SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462170",
            "telephone_number": "616-336-7662",
            "fax_number": "616-336-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4081 CASCADE RD SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462170",
            "telephone_number": "616-336-7662",
            "fax_number": "616-336-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN PREFONTAINE, DO, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "PREFONTAINE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-336-7662",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101011668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Stepanovich
• Molly Stephan, BA
• Nicholas Alexander Stephanoff, M.D.
• Robert Thomas Stephans, MSW, LMSW, ADS
• Stephen C. Dalm DO PC (Grand Rapids OB/GYN)
• Delaney Stephens
• Eden Amber Stephens, LLMSW
• Nicholas Stephens
• Stacey Madeline Stephens, PT, DPT
• Jordan Stephenson, LMSW

• Family Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.