Stoller, Clifford R

Stoller, Clifford R is an sole proprietor health care provider with primary practice located at 6100 Seagull St Ne Suite 106, Albuquerque NM 87109-2500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Stoller, Clifford R can be contacted via phone (505) 883-4395.

Contact Information

Primary practice address
6100 Seagull St Ne Suite 106 Albuquerque NM 87109-2500
Phone: (505) 883-4395
Fax: (505) 883-4397
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 82-316 New Mexico

Profile Details

NPI number 1053327361
LBN Legal business name Stoller, Clifford R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2006
Last updated Jul 9th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053327361 NPPES
New Mexico MEDICAID 000037341

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