Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 001970 | MI |
NPI | 1063435659 |
---|---|
Provider Name | Dr. Stacy A Uebele |
First Address | Hastings, MI 49058 |
Second Address | Hastings, MI 49058-1712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4710193 | (05) | MI |
4710219 | (05) | MI |
4766591 | (05) | MI |
U86206 | (02) |