Stoller, Kenneth Paul

Stoller, Kenneth Paul is an sole proprietor health care provider with primary practice located at 330 Paseo Del Pueblo Sur Ste J , Taos NM 87571-5328. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine is his primary health care specialty. Stoller, Kenneth Paul can be contacted via phone (505) 288-9155.

Contact Information

Primary practice address
330 Paseo Del Pueblo Sur Ste J Taos NM 87571-5328
Phone: (505) 288-9155
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 207PE0005X A41183 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 97382 New Mexico
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A41183 California
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 207PE0005X 97382 New Mexico

Profile Details

NPI number 1063518967
LBN Legal business name Stoller, Kenneth Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2006
Last updated Mar 18th, 2021 - about 3 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 1063518967 NPPES
New Mexico MEDICAID Z7406

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