Individual
DR. PAUL KREHL STILLWAGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1828 W PLAZA DR, WINCHESTER, VA 22601-6365
(540) 662-9115
(540) 665-0411
Mailing address
PO BOX 2076, SKYLAND, NC 28776-2076
(828) 575-2644
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
0101039785
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001717682
MOUNTAIN STATE BC/BS
VA
01
—
001717682
MOUNTAIN STATE BC/BS
WV
05
—
006082602
—
VA
05
—
0070369000
—
WV
01
—
032685
ANTHEM BC/BS
VA
01
—
VVI896A
MEDICARE PTAN
VA
Enumeration date
07/14/2005
Last updated
11/17/2015
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