Provider Demographics
NPI:1265687198
Name:KUHFAHL, STACEY MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:MARIE
Last Name:KUHFAHL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:MARIE
Other - Last Name:CORYELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17021 OLD ORCHARD RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958
Mailing Address - Country:US
Mailing Address - Phone:302-329-8712
Mailing Address - Fax:302-481-1330
Practice Address - Street 1:17021 OLD ORCHARD RD UNIT 4
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-329-8712
Practice Address - Fax:302-481-1330
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08910400207R00000X
DEC2-0023949207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine