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Individual
DR. CHAD STOLLER
Active
Individual
DR. CHAD STOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013438A
IN
363A00000X
Physician Assistant
5601003571
MI
363AM0700X
Medical Physician Assistant
5601003571
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970021317
RAILROAD MEDICARE
—
Enumeration date
09/13/2005
Last updated
07/22/2020
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