Healthcare Provider Details

I. General information

NPI: 1477566529
Provider Name (Legal Business Name): ANDREW MICHAEL STONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 WOODLAND AVE
PHILADELPHIA PA
19104-4551
US

IV. Provider business mailing address

611 W UPSAL ST
PHILADELPHIA PA
19119-3627
US

V. Phone/Fax

Practice location:
  • Phone: 215-823-5800
  • Fax: 214-823-4040
Mailing address:
  • Phone: 215-848-7859
  • Fax: 215-848-4948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD028534E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberMD 028534E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: