Individual
DR. KATHERINE L STAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
713 TROY SCHENECTADY RD, SUITE 215, LATHAM, NY 12110-2490
(518) 713-5347
(518) 713-5359
Mailing address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
211086
NY
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
211086
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000490182005
BSNENY
NY
05
—
01871636
—
NY
01
—
070820000064
FIDELIS
NY
01
—
08885
MVP
NY
01
—
10027960
CDPHP
NY
01
—
119580
GHI/HMO
NY
01
—
201082
SENIOR WHOLE HEALTH
NY
01
—
5551692
AETNA
NY
01
—
6D0821
EMPIRE BC
NY
Enumeration date
10/12/2006
Last updated
03/14/2012
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