Organization
CHARLES BLANCHARD STOER MD PA
Active
Organization
CHARLES BLANCHARD STOER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES BLANCHARD STOER MD (PHYSICIAN)
(352) 377-8619
Entity
Organization
Contact information
Practice address
4525 SW 13TH ST, GAINESVILLE, FL 32608-3901
(352) 377-8619
(352) 371-9674
Mailing address
4525 SW 13TH ST, GAINESVILLE, FL 32608-3901
(352) 377-8619
(352) 371-9674
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
363A00000X
Physician Assistant
PA9103783
FL
363L00000X
Nurse Practitioner
ARNP1942732
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003FQ
FLORIDA BLUE
FL
01
—
9642865
AETNA
FL
01
—
DO4107
RAILROAD MEDICARE
FL
Enumeration date
05/06/2008
Last updated
03/24/2015
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