Basic Information
| Provider Information | |||||||||
| NPI: | 1174518757 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STOLLSTEIMER | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 UNIVERSITY DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | NEWTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189401873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157105522 | ||||||||
| FaxNumber: | 2157105181 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 FLORAL VALE BLVD STE B | ||||||||
| Address2: | |||||||||
| City: | YARDLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190675522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673649100 | ||||||||
| FaxNumber: | 2673649101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2005 | ||||||||
| LastUpdateDate: | 05/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD051184L | PA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0016448620006 | 05 | PA | MEDICAID | 908535 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 5134565 | 01 | PA | CIGNA PA | OTHER | 5569545 | 01 | PA | AETNA | OTHER |