Individual
DAVID STAHL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21 N MAIN ST, MIDDLEPORT, NY 14105-1027
(716) 735-7774
(716) 735-3036
Mailing address
21 N MAIN ST, MIDDLEPORT, NY 14105-1027
(716) 735-7774
(716) 735-3036
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
142618
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010171801
UNIVERA
NY
01
—
00508488001
BC/BS WNY
NY
05
—
00737173
—
NY
01
—
0401199
IHA
NY
01
—
040426003611
FIDELIS
NY
01
—
100908BJ
PREFERRED CARE
NY
Enumeration date
11/15/2005
Last updated
07/08/2007
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