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Contact Information

KENNETH P STOLLER, MD
330 PASEO DEL PUEBLO SUR STE J
TAOS, NM87571-5328
 Phone: 505-288-9155
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Undersea and Hyperbaric Medicine

207PE0005X 93 Physician/Emergency Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KENNETH P STOLLER · (Male)

NPI Number 1063518967
Status Active
Credentials MD
Entity Individual
Enumeration date 09/16/2006
Last updated 03/18/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A41183
  • NM License # 97382
  • NM Medicaid Z7406
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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