# PAUL T. STOCKMANN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588664932
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | 01078636A | IN | Yes |
| 2086S0120X | Pediatric Surgery Physician | 057466 | MI | — |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 04/23/2018

## 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 | — |