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General NPI Number Information
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NPI Number | 1003575457
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Entity Type | Individual
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Provider Name | STEPHEN MICHAEL PISTOIA JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/14/2021
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 750 KINGS HWY STE 110
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City | LEWES
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State | DE
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Zip | 19958-1772
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Country | US
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Telephone | 302-644-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 34031 SANDCASTLE DR N
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City | MILLSBORO
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State | DE
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Zip | 19966-6009
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Country | US
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Telephone | 609-929-0733
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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