1912098948 NPI number — NEIL I STAHL MD

Table of content: NEIL I STAHL MD (NPI 1912098948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912098948 NPI number — NEIL I STAHL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STAHL
Provider First Name:
NEIL
Provider Middle Name:
I
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912098948
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2730 UNIVERSITY BLVD W STE 310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHEATON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20902-1990
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-942-7600
Provider Business Mailing Address Fax Number:
703-573-7767

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8270 WILLOW OAKS CORPORATE DR STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031-4530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-942-7600
Provider Business Practice Location Address Fax Number:
703-573-7767
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  0101030269 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 541873924 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5833094 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110176686 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 065856 . This is a "BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4279696 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 210210 . This is a "TRIGON FEP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 333779 . This is a "ALLIANCE GEHA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com