Provider Demographics
NPI:1497736144
Name:STILLMAN, BELINDA ANN (DO)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:ANN
Last Name:STILLMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BELINDA
Other - Middle Name:ANN
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 LECOM PL
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-2571
Mailing Address - Country:US
Mailing Address - Phone:814-868-2507
Mailing Address - Fax:814-868-2522
Practice Address - Street 1:4740 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2008
Practice Address - Country:US
Practice Address - Phone:814-454-3174
Practice Address - Fax:814-616-8002
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0131372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013960410001Medicaid
PAI250007Medicare UPIN
PA1013960410001Medicaid