Healthcare Provider Details

I. General information

NPI: 1326019969
Provider Name (Legal Business Name): ROBERT J STIERWALT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 MONCLOVA RD
MAUMEE OH
43537-1855
US

IV. Provider business mailing address

7280 SAWMILL RUN
HOLLAND OH
43528-9687
US

V. Phone/Fax

Practice location:
  • Phone: 419-893-5968
  • Fax:
Mailing address:
  • Phone: 419-867-0715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.046716
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35046716
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: