Provider Demographics
NPI:1265669105
Name:HARR, STACY H (MD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:H
Last Name:HARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STACY
Other - Middle Name:L
Other - Last Name:HOLLOPETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3846 SULPHUR SPRING RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:43606-2324
Mailing Address - Country:US
Mailing Address - Phone:419-787-4101
Mailing Address - Fax:
Practice Address - Street 1:3846 SULPHUR SPRING RD
Practice Address - Street 2:
Practice Address - City:OTTAWA HILLS
Practice Address - State:OH
Practice Address - Zip Code:43606-2324
Practice Address - Country:US
Practice Address - Phone:419-787-4101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036130580208000000X
OH35.124213208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics