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General NPI Number Information
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NPI Number | 1548309446
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Entity Type | Organization
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Legal Business Name | DAVID STAHL, MD
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 21 N MAIN ST
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City | MIDDLEPORT
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State | NY
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Zip | 14105-1027
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Country | US
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Telephone | 716-735-7774
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Fax | 716-735-3036
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Provider Business Mailing Address
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Address Line | 21 N MAIN ST
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City | MIDDLEPORT
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State | NY
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Zip | 14105-1027
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Country | US
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Telephone | 716-735-7774
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Fax | 716-735-3036
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID D STAHL
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Credential | MD
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Telephone | 716-735-7774
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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 | 142618
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License Number State | NY
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