Individual
JENNIFER R. STOLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
90 SPRINGVIEW LN STE A, SUMMERVILLE, SC 29485-8153
(843) 832-9113
(843) 832-9114
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 832-9113
(843) 832-9114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39189
SC
2084P0800X
Psychiatry Physician
39189
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
391891
—
SC
01
—
P01722507
RR MEDICARE
SC
Enumeration date
07/05/2011
Last updated
06/10/2021
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