Individual
CONRAD J STACHELEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2508 MYRTLE STREET, SUITE 100, ERIE, PA 16505-2700
(814) 452-5400
(814) 454-2003
Mailing address
2508 MYRTLE STREET, SUITE 100, ERIE, PA 16505-2700
(814) 452-5400
(814) 454-2003
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD049426
PA
2085R0203X
Therapeutic Radiology Physician
MD049426L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001411566
—
PA
Enumeration date
06/21/2005
Last updated
10/11/2020
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