Individual
RICHARD A. STOLZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085005428
IL
363A00000X
Physician Assistant
1591
TN
363AS0400X
Surgical Physician Assistant
PA 9106393
FL
363AS0400X
Surgical Physician Assistant
PA0000001591
TN
363AS0400X
Surgical Physician Assistant
Primary
PA16710
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400253188
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
11/24/2006
Last updated
10/17/2023
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