MEDICARE: DR. SIMONNE STAHL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	209720	MA
2	207R00000X	Internal Medicine Physician	13360	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA195235	OTHER	NH	HPHC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1417020660	OTHER	NH	ANTHEM BCBS NH

General Provider Information

NPI Number	:	1417020660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMONNE STAHL MD

Provider Business Mailing Address
First Line	:	8 PROSPECT ST
Second Line	:	ADULT HOSPITALIST PROGRAM
City	:	NASHUA
State	:	NH
Zip	:	03061
Country	:	US
Telephone Number	:	603-577-2494
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 PROSPECT ST
Second Line	:	ADULT HOSPITALIST PROGRAM
City	:	NASHUA
State	:	NH
Zip	:	03061
Country	:	US
Telephone Number	:	603-577-2494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	01/18/2011

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