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KYLE STAHLBAUM PA-C NPI 1205611720


NPI Information

NPI: 1205611720
Provider Name: KYLE STAHLBAUM, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
928 E 10 MILE RD STE 400
FERNDALE, MI
ZIP 48220
Phone: (248) 268-4299
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Kyle Stahlbaum, PA-C is a medical physician assistant in Ferndale, MI with 1 years of experience. Kyle Stahlbaum, PA-C NPI is 1205611720. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WESTERN MICHIGAN UN HOMER STRYKER SCHOOL OF MED
Graduation Year:2023

The provider's business location address is:

928 E 10 MILE RD STE 400
FERNDALE, MI
ZIP 48220-041
Phone: (248) 268-4299

The NPI 1205611720 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/31/2023 and was last updated on 10/24/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical5601011970MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.