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General NPI Number Information
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NPI Number | 1124260872
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Entity Type | Organization
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Legal Business Name | PETER R. STAHL, M.D., P.C.
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Dates
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Enumeration Date | 03/26/2009
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 485 TITUS AVE SUITE D
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City | ROCHESTER
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State | NY
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Zip | 14617-3535
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Country | US
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Telephone | 585-266-0540
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Fax | 585-342-9566
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Provider Business Mailing Address
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Address Line | 485 TITUS AVE SUITE D
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City | ROCHESTER
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State | NY
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Zip | 14617-3535
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Country | US
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Telephone | 585-266-0540
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Fax | 585-342-9566
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Authorized Official
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Title or Position | M.D.
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Name | DR. PETER RICHARD STAHL
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Credential | M.D.
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Telephone | 585-266-0540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 106640
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License Number State | NY
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