Individual
DR. NICHOLAS C STILWELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
264 E BROAD ST, BETHLEHEM, PA 18018-6224
(610) 866-9311
(610) 882-2072
Mailing address
716 SHADYWOOD DR, PERKASIE, PA 18944-1541
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS008639L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01340101
CAPITAL BLUE CROSS
PA
01
—
13193
HIGHMARK
PA
01
—
1661334
INDEPENDENCE BLUE CROSS
PA
01
—
5608734
AETNA
PA
Enumeration date
10/11/2005
Last updated
07/08/2007
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