Stephanie Nicole Boldt, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Flint, MI
NPI 1619660404 · NPPES record last updated Jun 2, 2023
Key facts
- NPI
- 1619660404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 4351050859 (MI)
- Practice address
- 401 S Ballenger Hwy Ofc 7N
Flint, MI 48532-3638 - Phone
- (810) 342-2000
- Fax
- (810) 342-3659
- NPI assigned
- May 30, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230613001721 | MI | Order and Referring Only - Anesthesiology |
3375900921 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4351050859 | MI | Yes |
Addresses
Primary practice location
401 S Ballenger Hwy Ofc 7N
Flint, MI 48532-3638
Mailing address
401 S Ballenger Hwy Ofc 7N
Flint, MI 48532-3638
Phone (810) 342-2000
Other providers in Flint, MI
- David Alan Boike
- Rebecca Sue Boisclair
- Clarence George Bolda Jr.
- Cynthia Bolden-Howard
- Cassandra Bolden
- Ashley L Boltjes
- Michael Dwayne Bolton
- Camrion Bona
- Brad Bruce Bond
- Renee Bondroff
All providers in Flint, MI · Student in an Organized Health Care Education/Training Program in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.