Doctor Name: | BENJAMIN ADAM STAHL |
NPI Number: | 1730404609 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | PI109789 |
Business Practice Address: | 100 Cross Roads Plz K-mart Pharmacy Mt Pleasant, PA - 156662287 |
Business Phone Number: | 7245470535 |
Business Fax Number: | |
Mailing Address: | 100 Cross Roads Plz, K-mart Pharmacy MT PLEASANT |
State: | PA |
Postal Code: | 156662287 |
Phone Number: | 7245470535 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2010 |
NPI Last Update Date: | 04/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | PI109789 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |