Provider Demographics
NPI:1376650341
Name:STURTZ, STEPHEN ARTHUR (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ARTHUR
Last Name:STURTZ
Suffix:
Gender:M
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:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-535-1900
Mailing Address - Fax:215-535-7950
Practice Address - Street 1:6557 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-2918
Practice Address - Country:US
Practice Address - Phone:215-535-1900
Practice Address - Fax:215-535-7950
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003456L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000591263Medicaid
PAP00780179OtherRAILROAD MEDICARE
PAP00217489OtherRAILROAD MEDICARE
PAP00780179OtherRAILROAD MEDICARE
PA000591263Medicaid