Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Johnathan Stephan, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1558942268

Johnathan Stephan, MD is a Student in an Organized Health Care Education/Training Program in Southfield, Michigan. Works from 2 locations. Licensed in Michigan and Ohio.

Licensed in
MI, OH
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

22250 Providence Dr Ste 705
Southfield, MI 48075
Phone: (248) 552-9858
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2799 W Grand Blvd, Detroit, MI 48202-2689 — (313) 916-1601

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence 4301514036 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 35.150818 (OH)

Record details

NPI number1558942268
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 15, 2021
Last updated in NPPESJuly 2, 2025
Certification dateJuly 2, 2025
Mailing address22250 Providence Dr Ste 705, Southfield, MI 48075-6215

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