Individual
RICHARD A STOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2930 W CLEVELAND RD, SOUTH BEND, IN 46628-6090
(574) 520-2707
(574) 520-2700
Mailing address
707 E CEDAR ST, STE 200, SOUTH BEND, IN 46617-2057
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037182
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000298320
BCBS
IN
05
—
100092390A
—
IN
Enumeration date
06/01/2006
Last updated
09/14/2016
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