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Charles W. Stotler
Medical Specialty Clinic/Center in Portage, Pennsylvania
NPI 1912141748

Charles W. Stotler is a Medical Specialty Clinic/Center based in Portage, PA and is specialized in Medical Specialty. Charles W. Stotler practices in Portage, PA. The NPI Number for Charles W. Stotler is 1912141748 and holds a License No. 017069E (Pennsylvania).

The current practice location address for Charles W. Stotler is 711 Caldwell Ave, Portage, PA and can be reached out via phone at 814-736-9628 and via fax at 814-736-3797.

Location: 711 Caldwell Ave, Portage, PA, 15946-1557
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912141748
Provider Name
Charles W. Stotler
Credential
Provider Entity Type
Organization
Address
711 Caldwell Ave, Portage, PA, 15946-1557
Phone Number
814-736-9628
Fax Number
814-736-3797
Provider Enumeration Date
04/23/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0007466700002 05 PA
institution
Provider Business Practice Location Address Details
Address
711 Caldwell Ave
City
Portage
State
Pennsylvania
Zip
15946-1557
Phone Number
814-736-9628
Fax Number
814-736-3797
person
Provider Business Mailing Address Details
Address
711 Caldwell Ave
City
Portage
State
Pennsylvania
Zip
15946-1557
Phone Number
814-736-9628
Fax Number
814-736-3797
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
017069E (Pennsylvania)
Definition
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).
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