Individual
EUGENE R. STISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 PENN ST, WEST HAZLETON, PA 18202-1514
(570) 497-4940
(570) 497-4942
Mailing address
PO BOX 1388, KINGSTON, PA 18704-0388
(570) 288-8881
(570) 288-8065
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD037411E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002708
FIRST PRIORITY HEALTH
—
01
—
182834
PA BLUE SHIELD
PA
01
—
182834
CAPITAL ADVANTAGE
—
01
—
710941282
HEALTH AMERICA
—
Enumeration date
05/13/2006
Last updated
03/27/2017
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