Individual
BRETT C STOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207RC0000X
Cardiovascular Disease Physician
21708
SC
207RI0011X
Interventional Cardiology Physician
Primary
21708
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217081
—
SC
01
—
P00970781
RR MEDICARE
SC
Enumeration date
12/21/2005
Last updated
01/16/2023
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