Individual provider Active NPI

Robert Andrew Stefan

  • Pharmacist
  • Sterling Heights, MI
National Provider Identifier
1205580669
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21112130424 Issued in MI
Practice address
38300 Van Dyke Ave Ste 102
Sterling Heights, MI 48312-1176
Phone
(586) 275-0422
Fax
(586) 722-7917
NPI assigned
Feb 4, 2022
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21112130424 MI Primary

Addresses

Primary practice location

38300 Van Dyke Ave Ste 102
Sterling Heights, MI 48312-1176

Mailing address

28718 Quarry CT
Novi, MI 48377-2721
Phone (248) 320-4423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21112130424MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1205580669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28718 QUARRY CT",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772721",
            "telephone_number": "248-320-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38300 VAN DYKE AVE STE 102",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483121176",
            "telephone_number": "586-275-0422",
            "fax_number": "586-722-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFAN",
        "first_name": "ROBERT",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "21112130424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.