Provider Demographics
NPI:1376075424
Name:KATHRYN STOEDTER DPM LLC
Entity Type:Organization
Organization Name:KATHRYN STOEDTER DPM LLC
Other - Org Name:COMPREHENSIVE FOOT & ANKLE CENTER OF SOUTH JERSEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:STOEDTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-768-7850
Mailing Address - Street 1:277 WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-2275
Mailing Address - Country:US
Mailing Address - Phone:856-768-7850
Mailing Address - Fax:856-768-7853
Practice Address - Street 1:277 WHITE HORSE PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-2275
Practice Address - Country:US
Practice Address - Phone:856-768-7850
Practice Address - Fax:856-768-7853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00296500213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty