Provider Demographics
NPI:1659576767
Name:STOFKO, BRITTANY MICHELE (DO)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MICHELE
Last Name:STOFKO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295A MIDLAND PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-5901
Mailing Address - Country:US
Mailing Address - Phone:438-518-3800
Mailing Address - Fax:843-851-7787
Practice Address - Street 1:295A MIDLAND PKWY STE 140
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-5901
Practice Address - Country:US
Practice Address - Phone:843-851-3800
Practice Address - Fax:843-851-7787
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC52094207V00000X
PAOS015623207V00000X
TNDO2784207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ015544Medicaid
TNQ015544Medicaid