Stephen Dehaan, PAC

Individual provider Active NPI Physician Assistant · White Cloud, MI

NPI 1407884257 · NPPES record last updated Oct 14, 2021

Key facts

NPI
1407884257
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
5601001543 (MI)
Practice address
555 E Wilcox Ave
White Cloud, MI 49349-7512
Phone
(231) 689-3268
Fax
(231) 689-1030
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Family Health Care Past Accepting new patients
Baldwin Family Health Care Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephen.dehaan.p1@direct.bfhc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601001543 MI Yes

Addresses

Primary practice location

555 E Wilcox Ave
White Cloud, MI 49349-7512

Mailing address

520 Cobb St
Cadillac, MI 49601-2588
Phone (231) 876-6527

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address stephen.dehaan.p1@direct.nextgenshare.com

Other providers in White Cloud, MI

All providers in White Cloud, MI · Physician Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.