Individual
PAUL LYNWOOD STAGG III
Active
Individual
PAUL LYNWOOD STAGG III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD-068636-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102262392
—
PA
01
—
1578658
GATEWAY HEALTH PLAN
PA
01
—
2088561
HIGHMARK BLUE SHIELD
PA
01
—
50084211
CAPITAL BLUE CROSS
PA
Enumeration date
01/08/2006
Last updated
09/11/2013
Update your record
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