| Doctor Name: | STEFAN JOHN KUIPERS |
| NPI Number: | 1194062638 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 5601006568 |
| Business Practice Address: | 955 S Bailey Ave South Haven, MI - 490906743 |
| Business Phone Number: | 2696375271 |
| Business Fax Number: | 2696392770 |
| Mailing Address: | 955 S Bailey Ave, SOUTH HAVEN |
| State: | MI |
| Postal Code: | 490906743 |
| Phone Number: | 2696375271 |
| Fax Number: | 2696392770 |
| NPI Enumeration Date: | 01/03/2013 |
| NPI Last Update Date: | 01/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601006568 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |