Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD034788E | PA |
N | 111NI0900X | Internist | MD034788E | PA |
Y | 207RH0000X | Hematologist | MD034788E | PA |
N | 207RH0003X | Hematology & Oncology | MD034788E | PA |
N | 207RX0202X | Medical Oncology | MD034788E | PA |
NPI | 1457394744 |
---|---|
Provider Name | Edward A Stadtmauer |
First Address | Philadelphia, PA 19104-5127 |
Second Address | Philadelphia, PA 19104-5127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 25/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011083860003 | (05) | PA |
B47351 | (02) |