Provider Demographics
NPI:1154333003
Name:STAHL, JOHN SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SAMUEL
Last Name:STAHL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:DEPT. NEUROLOGY, UNIV. HOSPITALS
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-5040
Mailing Address - Country:US
Mailing Address - Phone:216-844-3170
Mailing Address - Fax:216-844-5066
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:DEPT. NEUROLOGY, CLEVELAND VA MED CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-707-6401
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OH350707102084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH68453Medicare UPIN