MEDICARE: RICHARD SHELDON STAHL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	22207	CT
2	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	22207	CT
3	2086S0122X	Plastic and Reconstructive Surgery Physician	22207	CT

General Provider Information

NPI Number	:	1508800343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD SHELDON STAHL M.D.

Provider Business Mailing Address
First Line	:	5 DURHAM RD
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437-2076
Country	:	US
Telephone Number	:	203-458-4440
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 DURHAM RD
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437-2076
Country	:	US
Telephone Number	:	203-458-4440
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	10/11/2007

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