Healthcare Provider Details

I. General information

NPI: 1801537774
Provider Name (Legal Business Name): BENJAMIN STAMPFL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 S WEBSTER AVE STE 201
GREEN BAY WI
54301-3500
US

IV. Provider business mailing address

4229 REFORESTATION RD
SUAMICO WI
54313-8509
US

V. Phone/Fax

Practice location:
  • Phone: 920-430-7100
  • Fax:
Mailing address:
  • Phone: 920-664-2573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number87697-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: