Basic Information
| Provider Information | |||||||||
| NPI: | 1558439893 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALFRED STILLMAN - HOME VISIT DOCTORS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 VALLEY CENTER PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180172344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848844436 | ||||||||
| FaxNumber: | 4848844444 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 PENN BLVD | ||||||||
| Address2: | SUITE 3026 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191441476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158497700 | ||||||||
| FaxNumber: | 2158497631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 01/26/2010 | ||||||||
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| AuthorizedOfficialLastName: | STILLMAN | ||||||||
| AuthorizedOfficialFirstName: | ALFRED | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CO PROPRIETOR | ||||||||
| AuthorizedOfficialTelephone: | 2158497700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.