Provider Demographics
NPI:1457136566
Name:STELLARIA NATURAL MEDICINE PLLC
Entity Type:Organization
Organization Name:STELLARIA NATURAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYDE
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:207-756-3303
Mailing Address - Street 1:112 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6110
Mailing Address - Country:US
Mailing Address - Phone:207-756-3303
Mailing Address - Fax:
Practice Address - Street 1:112 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6110
Practice Address - Country:US
Practice Address - Phone:207-756-3303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty