# FRED STUTMAN

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

## Provider details

- **NPI number:** 1780660316
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD007124E | PA | Yes |

## Other

- **Enumeration date:** 12/15/2005
- **Last updated:** 10/21/2013

## 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 |