National Provider Identifier Database

CHARLES W STOTLER
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

CHARLES W. STOTLER
711 CALDWELL AVE
PORTAGE, PA15946-1557
Phone: 814-736-9628
Fax: 814-736-3797
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for CHARLES W. STOTLER

NPI Number 1912141748
Legal business name
LBN
CHARLES W. STOTLER
Authorized official KAREN SYBERT - (BILLING COORDINATOR)
Entity Organization
Organization subpart No
Enumeration date 04/23/2009
Last updated 04/23/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: 017069E
  • PA Medicaid: 0007466700002

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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