Organization
EAST PENN DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL B STIERSTORFER M.D. (PRESIDENT)
(215) 661-0300
Entity
Organization
Contact information
Practice address
311 N SUMNEYTOWN PIKE, STE 1E, NORTH WALES, PA 19454-2532
(215) 661-0300
(215) 661-0302
Mailing address
311 N SUMNEYTOWN PIKE, STE 1E, NORTH WALES, PA 19454-2532
(215) 661-0300
(215) 661-0302
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009001740001
—
PA
01
—
2230853
AETNA
PA
01
—
341275
BLUE SHIELD
PA
Enumeration date
06/23/2005
Last updated
11/22/2022
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