Individual
MRS. MARIA ADELL STUMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 THEDA MEDICAL PLAZA, SUITE 320, NEENAH, WI 54956
(920) 722-3341
(920) 729-2119
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 738-4780
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1078-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42975600
—
WI
Enumeration date
07/16/2006
Last updated
01/28/2011
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