Provider Demographics
NPI:1235195801
Name:STUMPF, PAUL GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GEORGE
Last Name:STUMPF
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 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:973-971-4179
Mailing Address - Fax:973-971-7905
Practice Address - Street 1:99 BEAUVOIR AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3533
Practice Address - Country:US
Practice Address - Phone:423-778-2580
Practice Address - Fax:423-778-7489
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12519207VE0102X, 207VG0400X
TN46854207VE0102X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV880330858OtherMEDIVERSAL, INC.
NJ3719461-005OtherCIGNA HEALTHCARE
NV4820OtherEVOLUTIONS
NV880330858OtherANTHEM BC/BS
NV294636OtherAHCCCS
NV880330858OtherGREAT-WEST HEALTHCARE
NJ1001205Medicaid
NV1235195801Medicaid
NJ223680351OtherTHE FIRST HEALTH NETWORK
NV880330858OtherTEACHERS HEALTH TRUST
NJ1001205Medicaid
NV880330858OtherTEACHERS HEALTH TRUST
NJ223680351OtherTHE FIRST HEALTH NETWORK