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General NPI Number Information
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NPI Number | 1447288121
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Entity Type | Individual
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Provider Name | TERRENCE A STOLL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 8540 W ATWATER DR
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City | GARDEN CITY
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State | ID
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Zip | 83714-1801
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Country | US
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Telephone | 208-880-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 8540 W ATWATER DR
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City | GARDEN CITY
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State | ID
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Zip | 83714-1801
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Country | US
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Telephone | 208-880-6010
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | M6733
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD 00047952
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | MD 00047952
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | MD 00047952
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | MD 00047952
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | MD 00047952
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MD 00047952
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License Number State | WA
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Taxonomy #8
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | MD 00047952
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License Number State | WA
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Taxonomy #9
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M6733
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License Number State | ID
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Taxonomy #10
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 3929
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License Number State | ND
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Taxonomy #11
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD 00047952
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License Number State | WA
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Taxonomy #12
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 3929
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License Number State | ND
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Taxonomy #13
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2963A
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License Number State | WY
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