Provider Demographics
NPI:1740250729
Name:STENMAN, NILS G (MD)
Entity type:Individual
Prefix:
First Name:NILS
Middle Name:G
Last Name:STENMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:694 GOOD DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2433
Mailing Address - Country:US
Mailing Address - Phone:717-397-8177
Mailing Address - Fax:717-397-2426
Practice Address - Street 1:694 GOOD DR
Practice Address - Street 2:SUITE 112
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-397-8177
Practice Address - Fax:717-397-2426
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424626207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101342532Medicaid
PA092707ESCMedicare ID - Type Unspecified
PA101342532Medicaid
092707E5FMedicare PIN