Provider Demographics
NPI:1700851862
Name:TIFFT, STEPHEN W (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:W
Last Name:TIFFT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:160 NORTH POINT BOULEVARD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-569-6481
Mailing Address - Fax:717-569-5213
Practice Address - Street 1:160 NORTH POINT BOULEVARD
Practice Address - Street 2:SUITE 110
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-569-6481
Practice Address - Fax:717-569-5213
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2007-10-25
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Provider Licenses
StateLicense IDTaxonomies
PAMD019948E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP002656OtherGATEWAY HEALTH PLAN
PA4471404OtherAETNA NON-HMO
PA539900OtherAETNA NON-HMO
PA153461OtherHIGHMARK BLUE SHIELD
PAB40046OtherHEALTH ASSURANCE
PA0006619300001Medicaid
PA01653801OtherCAPITAL BLUE CROSS
PA1142862OtherAMERIHEALTH MERCY HEALTH
PA0006619300003Medicaid
PA43413 S1BXOtherGEISINGER HEALTH PLAN
PA1142862OtherAMERIHEALTH MERCY HEALTH
PA153461OtherHIGHMARK BLUE SHIELD