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General NPI Number Information
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NPI Number | 1932454923
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Entity Type | Organization
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Legal Business Name | STOLL MEDICAL GROUP LLC
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 1528 WALNUT ST STE 950
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3628
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Country | US
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Telephone | 215-531-4564
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 WALNUT ST SUITE 950
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3604
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | STEVEN MATTHEW STOLL
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Credential | MD
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Telephone | 215-615-3020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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