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NPI Code Detail

MEDICARE: RICHARD D STAHL PA

MEDICARE: RICHARD D STAHL PA
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
1363A00000XPhysician AssistantPA557TN
2363A00000XPhysician AssistantPA10004944WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01141753OTHERWARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
20301978OTHERWAL&I
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760448294
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD D STAHL PA
Provider Business Mailing Address
First Line : PO BOX 2087
Second Line :
City : WENATCHEE
State : WA
Zip : 98807-2087
Country : US
Telephone Number : 509-663-8711
Fax Number :
Provider Business Practice Location Address
First Line : 916 KOALA AVE
Second Line :
City : OMAK
State : WA
Zip : 98841-9576
Country : US
Telephone Number : 509-826-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2006
Last Update Date : 05/31/2013

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Directions to “ RICHARD D STAHL PA” Practice Location

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