Provider Demographics
NPI:1225098882
Name:STOFMAN, GUY M (MD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:M
Last Name:STOFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 101836
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-0836
Mailing Address - Country:US
Mailing Address - Phone:412-232-5616
Mailing Address - Fax:412-232-8340
Practice Address - Street 1:1350 LOCUST ST
Practice Address - Street 2:SUITE G103
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-232-5616
Practice Address - Fax:412-232-8340
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034789E207Y00000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012467760001Medicaid
671443Medicare PIN
PA0012467760001Medicaid