Individual
CHARLES BLAIR STILLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.S.
Contact information
Practice address
175 N MEDICAL DR, SALT LAKE CITY, UT 84132-6967
(801) 581-6908
(801) 581-4385
Mailing address
175 N MEDICAL DR, SALT LAKE CITY, UT 84112-1103
(801) 581-6908
(801) 581-4385
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
6059746-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0289043
—
NJ
Enumeration date
11/22/2006
Last updated
02/27/2025
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