Healthcare Provider Details

I. General information

NPI: 1558439893
Provider Name (Legal Business Name): ALFRED STILLMAN - HOME VISIT DOCTORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PENN BLVD SUITE 3026
PHILADELPHIA PA
19144-1476
US

IV. Provider business mailing address

1650 VALLEY CENTER PKWY SUITE 100
BETHLEHEM PA
18017-2344
US

V. Phone/Fax

Practice location:
  • Phone: 215-849-7700
  • Fax: 215-849-7631
Mailing address:
  • Phone: 484-884-4436
  • Fax: 484-884-4444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALFRED E STILLMAN
Title or Position: CO PROPRIETOR
Credential: MD
Phone: 215-849-7700