Individual
JERUSHA E STAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
69 GROVE ST, NEW CANAAN, CT 06840-5325
(844) 359-8363
Mailing address
3362 SOUTHVIEW DR, EUGENE, OR 97405-6243
(917) 232-1821
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
214779
OR
207R00000X
Internal Medicine Physician
61425057
WA
207R00000X
Internal Medicine Physician
Primary
76444
CT
207R00000X
Internal Medicine Physician
A101309
CA
261QM2500X
Medical Specialty Clinic/Center
1043889967
NY
261QM2500X
Medical Specialty Clinic/Center
1992372403
CT
261QM2500X
Medical Specialty Clinic/Center
1992372403
NJ
Other
Enumeration date
11/13/2007
Last updated
11/16/2023
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