Healthcare Provider Details

I. General information

NPI: 1952883910
Provider Name (Legal Business Name): JOHN STAMMERS MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CHESTNUT ST FL 5
PHILADELPHIA PA
19107-4290
US

IV. Provider business mailing address

1500 LOCUST ST APT 1520
PHILADELPHIA PA
19102-4315
US

V. Phone/Fax

Practice location:
  • Phone: 267-297-2440
  • Fax:
Mailing address:
  • Phone: 215-452-9736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberLT000373
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: