Provider Demographics
NPI:1275943730
Name:MOELLER, STEFANIE MARIE (MD)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:MARIE
Last Name:MOELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:830 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:OH
Mailing Address - Zip Code:45828-1626
Mailing Address - Country:US
Mailing Address - Phone:567-890-7143
Mailing Address - Fax:419-586-0812
Practice Address - Street 1:442 STACHLER DR
Practice Address - Street 2:
Practice Address - City:SAINT HENRY
Practice Address - State:OH
Practice Address - Zip Code:45883-9582
Practice Address - Country:US
Practice Address - Phone:419-678-2371
Practice Address - Fax:419-678-4783
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.131882207R00000X
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program