Wayne Kenneth Stefanciw, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301032942 Issued in MI

Practice address

3922 Cedar Run Rd
Traverse City, MI 49684-9687

Phone

(231) 935-0322

Fax

(231) 935-0334

NPI assigned

Nov 3, 2005

Last updated

Jul 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1487645842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3922 CEDAR RUN RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849687",
            "telephone_number": "231-935-0322",
            "fax_number": "231-935-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3922 CEDAR RUN RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849687",
            "telephone_number": "231-935-0322",
            "fax_number": "231-935-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANCIW",
        "first_name": "WAYNE",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301032942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3480034",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Grace Stauffer, PA
• Gary Edward Stauffer, M.S.W., A.C.S.W.
• Jane Marie Stauffer, NP
• Joseph M Stayman, DDS
• Christopher James Steele, MD
• Corbin John Stefanski, DPT
• David John Steffey, MD
• Madison B Steggles
• Kris A. Stegmann, DDS
• Elizabeth Stelzer

• Urology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.