Individual
RUSSELL FRANK STAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 DOUG WHITE DR STE 420, MYRTLE BEACH, SC 29572-4182
(843) 497-7772
(843) 848-7530
Mailing address
920 DOUG WHITE DR STE 420, MYRTLE BEACH, SC 29572-4182
(843) 497-7772
(843) 848-7530
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
39914
SC
174400000X
Specialist
97608
GA
174400000X
Specialist
MD-033209E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016335280009
—
PA
05
—
01633528
—
PA
Enumeration date
09/21/2005
Last updated
08/05/2025
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