Basic Information
| Provider Information | |||||||||
| NPI: | 1831197045 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STOLL | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | RONALD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Practice Location | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2005 | ||||||||
| LastUpdateDate: | 05/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD419657 | PA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 0208746000 | 01 | INDEPENDENCE BLUE CROSS | OTHER | 1398626 | 01 | HIGHMARK BLUE SHIELD | OTHER | 2150109 | 01 | UNITED HEALTHCARE | OTHER | 2170565 | 01 | MAMSI | OTHER | 0208746000 | 01 | AMERIHEALTH | OTHER | 260051063 | 01 | RAILROAD MEDICARE | OTHER | 50011845 | 01 | KEYSTONE HEALTH CENTRAL | OTHER | 0208746000 | 01 | KEYSTONE HEALTH EAST | OTHER | 3286904 | 01 | HEALTH AMERICA/HEALTH ASS | OTHER | 9244337 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | P3159655 | 01 | OXFORD HEALTH PLANS | OTHER | 0019034540003 | 05 | PA | MEDICAID | 3001265 | 01 | AETNA PPO | OTHER | 50011845 | 01 | CAPITAL BLUE CROSS | OTHER | 75928 | 01 | GEISINGER HEALTH PLAN | OTHER | 821137 | 01 | FIRST PRIORITY HEALTH | OTHER |