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Individual

ERIC TODD STALLKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
582 N CABLE RD, LIMA, OH 45805-2133
(419) 996-2500
(419) 996-2509
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-0001
(513) 981-5123
(513) 981-5015

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
350731165
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000136496
ANTHEM BC/BS PROVIDER #
OH
01
080142578
TRAVELERS/RAILROAD MEDICA
OH
01
1134112469
GROUP NPI# PRIMARY OFFICE
01
1669550182
GROUP NPI# SATELLITE OFFI
05
2062075
OH
Enumeration date
09/13/2005
Last updated
09/10/2013
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