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Individual

EDWARD STACHOWIAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
ROUTES 940 & 115, BLAKESLEE, PA 18610
(570) 646-8745
(570) 646-8962
Mailing address
610 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 288-5441
(570) 288-5842

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD044630L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001243308
PA
05
0012433080007
PA
Enumeration date
06/26/2006
Last updated
09/18/2012
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