Provider Demographics
NPI:1669478913
Name:STUEMPFLE, RICHARD G (DPM)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:STUEMPFLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-2556
Mailing Address - Country:US
Mailing Address - Phone:570-748-5527
Mailing Address - Fax:570-748-5010
Practice Address - Street 1:36 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2556
Practice Address - Country:US
Practice Address - Phone:570-748-5527
Practice Address - Fax:570-748-5010
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC000444L213E00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
T27390Medicare UPIN
PA048095Medicare PIN
0158900001Medicare NSC