Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35095028 | OH |
Y | 208000000X | Pediatrician | 4301085739 | MI |
N | 2080N0001X | Neonatal-Perinatal Doctor | 4301085739 | MI |
N | 2080P0214X | Pediatric Pulmonologist | 4301085739 | MI |
NPI | 1568588804 |
---|---|
Provider Name | Dr. Christine Susanne Stahle |
First Address | Maumee, OH 43537-1745 |
Second Address | Maumee, OH 43537-1745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 26/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3094351 | (05) | OH |