Stadalsky, John Scott
Stadalsky, John Scott is an individual health care provider with primary practice located at 105 Springhall Dr , Goose Creek SC 29445-5370. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Stadalsky, John Scott can be contacted via phone (843) 766-6308.Contact Information
Primary practice address
105 Springhall Dr
Goose Creek SC 29445-5370
Phone: (843) 766-6308
Fax: (866) 533-4473
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 24015 | South Carolina |
Profile Details
| NPI number | 1699720250 |
|---|---|
| LBN Legal business name | Stadalsky, John Scott |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Dec 20th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699720250 | NPPES |
| South Carolina | MEDICAID | T83086 | |
| South Carolina | Other | 571020809007 | |
| South Carolina | Other | 571020809042 |
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