Provider Demographics
NPI:1467483214
Name:HERSHFELD, STACY L (DO)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:L
Last Name:HERSHFELD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:111 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6144
Mailing Address - Country:US
Mailing Address - Phone:207-779-2628
Mailing Address - Fax:207-779-2303
Practice Address - Street 1:131 FRANKLIN HEALTH CMNS
Practice Address - Street 2:SUITE F
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6142
Practice Address - Country:US
Practice Address - Phone:207-778-4922
Practice Address - Fax:207-779-0646
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME1735207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEH60493Medicare UPIN
MEMM9386Medicare ID - Type Unspecified