Healthcare Provider Details

I. General information

NPI: 1912098948
Provider Name (Legal Business Name): NEIL I STAHL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 12/30/2021
Certification Date: 10/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8270 WILLOW OAKS CORPORATE DR STE 150
FAIRFAX VA
22031-4530
US

IV. Provider business mailing address

2730 UNIVERSITY BLVD W STE 310
WHEATON MD
20902-1990
US

V. Phone/Fax

Practice location:
  • Phone: 301-942-7600
  • Fax: 703-573-7767
Mailing address:
  • Phone: 301-942-7600
  • Fax: 703-573-7767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number0101030269
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: