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STOLL MEDICAL GROUP LLC NPI 1932454923


NPI Information

NPI: 1932454923
Provider Name: STOLL MEDICAL GROUP LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 39D2055179

Address:
1528 WALNUT ST STE 950
PHILADELPHIA, PA
ZIP 19102
Phone: (215) 531-4564
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STOLL MEDICAL GROUP LLC is a family medicine in Philadelphia, PA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. STOLL MEDICAL GROUP LLC NPI is 1932454923. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1528 WALNUT ST STE 950
PHILADELPHIA, PA
ZIP 19102-628
Phone: (215) 531-4564

The provider's authorized official is Steven Matthew Stoll .
The authorized official title is Provider/owner and has the following contact phone number (215) 615-3020.

The CLIA number assigned to this NPI record is 39D2055179 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/17/2012 and was last updated on 9/27/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11027200860002MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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