Provider Demographics
NPI:1114506847
Name:STUNDER, STEPHEN III
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:STUNDER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CONCORD PL
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2030
Mailing Address - Country:US
Mailing Address - Phone:215-806-1464
Mailing Address - Fax:
Practice Address - Street 1:18 CONCORD PL
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-2030
Practice Address - Country:US
Practice Address - Phone:215-806-1464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006351101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health