Individual
DR. CAROLYN STULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 316-5151
Mailing address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
125071779
IL
207N00000X
Dermatology Physician
Primary
MD474043
PA
207R00000X
Internal Medicine Physician
MT213911
PA
Other
Enumeration date
06/09/2017
Last updated
07/01/2021
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