Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 4301108085 | MI |
N | 208200000X | Surgeon | MD60445640 | WA |
N | 208600000X | Surgeon | MD60445640 | WA |
N | 2086S0102X | Surgical Critical Care | 37504 | OK |
N | 2086S0102X | Surgical Critical Care | 4301108085 | MI |
Y | 2086S0102X | Surgical Critical Care | A127403 | CA |
NPI | 1174834055 |
---|---|
Provider Name | Dr. Stephanie Rae Downing |
First Address | Grand Rapids, MI 49525-3914 |
Second Address | Moreno Valley, CA 92555-3927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2010 |
Last Update Date | 14/05/2021 |