Individual
DR. KENNETH STILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
112 MAIN ST, NORTHBOROUGH, MA 01532-1914
(508) 351-9250
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42871
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2071738
—
MA
Enumeration date
11/27/2005
Last updated
06/07/2011
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