Provider Demographics
NPI:1568809127
Name:STOLBERG, BUCK (DO)
Entity Type:Individual
Prefix:
First Name:BUCK
Middle Name:
Last Name:STOLBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HIGH ST
Mailing Address - Street 2:DEPT. EMERGENCY MEDICINE - BUFFALO GENERAL HOSPITAL
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1126
Mailing Address - Country:US
Mailing Address - Phone:559-321-6928
Mailing Address - Fax:206-600-3144
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:DEPT. EMERGENCY MEDICINE - BUFFALO GENERAL HOSPITAL
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-1499
Practice Address - Fax:716-859-1555
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program