Healthcare Provider Details

I. General information

NPI: 1538153523
Provider Name (Legal Business Name): STUART D STYLE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 E EVESHAM RD STE 101A
VOORHEES NJ
08043-1557
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-795-4330
  • Fax: 856-325-3704
Mailing address:
  • Phone: 856-795-4330
  • Fax: 856-325-3704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS007461L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB05698300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: