Individual
FRED STUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3501 NEWBERRY RD, PHILA, PA 19154-2608
(215) 632-1400
(215) 632-2176
Mailing address
PO BOX 820933, PHILA, PA 19182-0933
(215) 632-1400
(215) 632-2176
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD007124E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000612309
—
PA
01
—
0047315
AETNA HMO
PA
01
—
0058304000
INDEPENDENCE BLUE CROSS
PA
01
—
016618
HIGHMARK BLUE SHIELD
PA
01
—
1081468
KEYSTONE MERCY HEALTH
PA
01
—
2Y0397
HEALTH NET
PA
01
—
4076190
AETNA PPO
—
01
—
597586
MEDICARE GROUP
PA
01
—
714
BRAVO HEALTH
PA
01
—
P00208191
RAILROAD MEDICARE
PA
01
—
P495461
OXFORD
PA
Enumeration date
12/15/2005
Last updated
10/21/2013
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