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Individual

HEATHER ELIZABETH STOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4510 N PROGRESS AVE, HARRISBURG, PA 17110-3925
(717) 412-7622
Mailing address
4510 N PROGRESS AVE, HARRISBURG, PA 17110-3925
(717) 412-7622

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD436659
PA
208M00000X
Hospitalist Physician
MD436659
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10237268
PA
01
1583951
GATEWAY
PA
01
2117412
HIGHMARK BLUE SHIELD
PA
01
415666
UPMC
PA
Enumeration date
08/27/2007
Last updated
10/02/2012
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