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Contact Information

STACY S BULL, MD
463 E CIRCLE DR
EAST LANSING, MI48824
 Phone: 517-884-6502
 Fax: 517-432-9460
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for STACY S BULL · (Female)

NPI Number 1619071115
Status Active
Credentials MD
Entity Individual
Enumeration date 09/13/2006
Last updated 09/07/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301070974
  • MI Medicaid 1619071115
  • MI Medicaid 4546883
  • MI Other 0803310501 BCBS INDIVIDUAL PIN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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