Healthcare Provider Details

I. General information

NPI: 1467662726
Provider Name (Legal Business Name): TERRI LYNN STILLWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

4401 PENN AVE
PITTSBURGH PA
15224-1334
US

V. Phone/Fax

Practice location:
  • Phone: 412-864-8977
  • Fax:
Mailing address:
  • Phone: 412-864-8977
  • Fax: 412-692-7016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT185625
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD433851
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301097868
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number4301097868
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberMD433851
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: