Organization Active NPI

D L Stageman MD PLC

  • Otolaryngology Physician
  • Holland, MI
National Provider Identifier
1972819134
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301039644 Issued in MI
Legal business name
D L STAGEMAN MD PLC
Practice address
926 Washington Ave
BLD D Ste 230
Holland, MI 49423-7725
Phone
(616) 396-3544
Fax
(616) 396-3548
NPI assigned
Aug 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Authorized official

Name
Donald L Stageman, MD
Title
Owner
Phone
(616) 396-3544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 4301039644 MI Primary

Addresses

Primary practice location

926 Washington Ave
BLD D Ste 230
Holland, MI 49423-7725

Mailing address

926 Washington Ave
BLD D Ste 230
Holland, MI 49423-7725
Phone (616) 396-3544

Other identifiers 1

IdentifierTypeStateIssuer
1427056118MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1972819134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 WASHINGTON AVE",
            "address_2": "BLD D STE 230",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237725",
            "telephone_number": "616-396-3544",
            "fax_number": "616-396-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 WASHINGTON AVE",
            "address_2": "BLD D STE 230",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237725",
            "telephone_number": "616-396-3544",
            "fax_number": "616-396-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D L STAGEMAN MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "STAGEMAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-396-3544",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301039644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427056118",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.