Stahl, Russell Frank
Stahl, Russell Frank is an individual health care provider with primary practice located at 920 Doug White Dr Ste 510 , Myrtle Beach SC 29572-4183. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Stahl, Russell Frank can be contacted via phone (843) 497-7772.Contact Information
Primary practice address
920 Doug White Dr Ste 510
Myrtle Beach SC 29572-4183
Phone: (843) 497-7772
Fax: (843) 848-7530
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 39914 | South Carolina |
| Other Service Providers / Specialist | 174400000X | MD-033209E | Pennsylvania |
Profile Details
| NPI number | 1760478242 |
|---|---|
| LBN Legal business name | Stahl, Russell Frank |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2005 |
| Last updated | Jan 26th, 2022 - about 4 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 | 1760478242 | NPPES |
| Pennsylvania | MEDICAID | 0016335280009 | |
| Pennsylvania | MEDICAID | 01633528 |
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