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General NPI Number Information
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NPI Number | 1346249836
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Entity Type | Individual
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Provider Name | DEBRA STULTZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 6171 CHILDERS RD
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1227
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Country | US
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Telephone | 304-733-5380
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Fax | 304-733-5796
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Provider Business Mailing Address
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Address Line | PO BOX 457
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-0457
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Country | US
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Telephone | 304-733-5380
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Fax | 304-733-5796
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 16672
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 16672
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License Number State | WV
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