Provider Demographics
NPI:1255610382
Name:STUHLTRAGER, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:STUHLTRAGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 BACKLINE RD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-8452
Mailing Address - Country:US
Mailing Address - Phone:856-433-0004
Mailing Address - Fax:
Practice Address - Street 1:501 E BASIN RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4230
Practice Address - Country:US
Practice Address - Phone:302-328-4173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004169183500000X
NJ28RL03438000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist