Stoller, Diane K

Stoller, Diane K is an sole proprietor health care provider with primary practice located at 144 State Street Mercy Hospital, Portland ME 04101-3795. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Hospitals / Critical Access. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Stoller, Diane K can be contacted via phone (207) 553-6808.

Contact Information

Primary practice address
144 State Street Mercy Hospital Portland ME 04101-3795
Phone: (207) 553-6808
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 30027 Minnesota
Hospitals / Critical Access 282NC0060X MD21011 Maine

Profile Details

NPI number 1134207160
LBN Legal business name Stoller, Diane K
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Dec 14th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134207160 NPPES
Minnesota Other 04Q32ST BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 154585000 BLUE CROSS BLUE SHIELD

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