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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