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Individual
FRED STUTMAN
Active
Individual
FRED STUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD007124E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000612309
—
PA
01
—
0047315
AETNA HMO
PA
01
—
0058304000
INDEPENDENCE BLUE CROSS
PA
01
—
016618
HIGHMARK BLUE SHIELD
PA
01
—
1081468
KEYSTONE MERCY HEALTH
PA
01
—
2Y0397
HEALTH NET
PA
01
—
4076190
AETNA PPO
—
01
—
597586
MEDICARE GROUP
PA
01
—
714
BRAVO HEALTH
PA
01
—
P00208191
RAILROAD MEDICARE
PA
01
—
P495461
OXFORD
PA
Enumeration date
12/15/2005
Last updated
10/21/2013
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