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Individual
PAUL T. STOCKMANN
Active
Individual
PAUL T. STOCKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
01078636A
IN
2086S0120X
Pediatric Surgery Physician
057466
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020H277290
BLUE CROSS BLUE SHIELD MI
MI
01
—
1396817714
GROUP NPI
MI
05
—
3289600
—
MI
05
—
329955410
—
MI
05
—
4115660
—
MI
01
—
700H262310
BLUE CROSS-BLUE CROSS
—
01
—
PS057466
CHAMPUS-CHAMPUS
—
Enumeration date
07/28/2005
Last updated
04/23/2018
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