Provider Demographics
NPI:1851330542
Name:STONER, MELANIE RUTH (PA-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:RUTH
Last Name:STONER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:RUTH
Other - Last Name:KNARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:2813 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:MIFFLINTOWN
Practice Address - State:PA
Practice Address - Zip Code:17059-9078
Practice Address - Country:US
Practice Address - Phone:717-436-8283
Practice Address - Fax:717-436-5594
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051868363A00000X
PAOA002252363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102232F6KMedicare PIN