| Stoll Medical Group Llc | |
|
1528 Walnut St Ste 950 Philadelphia PA 19102-3628 | |
| (215) 531-4564 | |
| Not Available |
| Full Name | Stoll Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1528 Walnut St Ste 950, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Steven Matthew Stoll (PROVIDER/OWNER) |
| Authorized Official Contact | 2156153020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stoll Medical Group Llc 1528 Walnut St Suite 950 Philadelphia PA 19102-3604 Ph: () - | Stoll Medical Group Llc 1528 Walnut St Ste 950 Philadelphia PA 19102-3628 Ph: (215) 531-4564 |
| NPI Number | 1932454923 |
|---|---|
| Provider Enumeration Date | 07/17/2012 |
| Last Update Date | 09/27/2018 |
| Medicare PECOS PAC ID | 2961659966 |
|---|---|
| Medicare Enrollment ID | O20120827000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932454923 | NPI | - | NPPES |
| 1027200860002 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Steven M Stoll |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518192004 PECOS PAC ID: 5799940730 Enrollment ID: I20120626000250 |
| Provider Name | Rachel Miller Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114365830 PECOS PAC ID: 8820239650 Enrollment ID: I20130720000245 |
| Provider Name | Jessica L Desalvo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780970442 PECOS PAC ID: 8224279369 Enrollment ID: I20140220000571 |
| Provider Name | Jonah Mink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083052351 PECOS PAC ID: 5294025888 Enrollment ID: I20160909000649 |
| Provider Name | Elizabeth Hayward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659815397 PECOS PAC ID: 2668754441 Enrollment ID: I20170201000058 |
| Provider Name | Aekata Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972984458 PECOS PAC ID: 8729337324 Enrollment ID: I20180815000547 |
| Provider Name | Katherine L Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083957799 PECOS PAC ID: 3577842681 Enrollment ID: I20181107003131 |
| Provider Name | Adam Jarrett Lyons |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1679950562 PECOS PAC ID: 9436482692 Enrollment ID: I20190604001199 |
| Provider Name | Bryan Andrew Botti |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1609262161 PECOS PAC ID: 2264744366 Enrollment ID: I20190815000045 |
| Provider Name | Naeha Gupta |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1588028799 PECOS PAC ID: 8325466204 Enrollment ID: I20200909000690 |
| Provider Name | Joanna Yun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316202450 PECOS PAC ID: 1355659574 Enrollment ID: I20201116002192 |
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