Doctor Name: | DR. MICHAEL A STICKLER |
NPI Number: | 1962456723 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME 88808 |
Business Practice Address: | 2420 Jenks Ave Suite C 1 Panama City, FL - 324054909 |
Business Phone Number: | 8502333376 |
Business Fax Number: | 8505228354 |
Mailing Address: | 2505 Harrison Ave, PANAMA CITY |
State: | FL |
Postal Code: | 324054423 |
Phone Number: | 8502333376 |
Fax Number: | 8505228354 |
NPI Enumeration Date: | 05/19/2006 |
NPI Last Update Date: | 10/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME 88808 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |