Provider Demographics
NPI:1780261529
Name:STAHL, COURTNEY-LYNN VICTORIA (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY-LYNN
Middle Name:VICTORIA
Last Name:STAHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:COURTNEY-LYNN
Other - Middle Name:VICTORIA
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7423 S MASON MONTGOMERY RD STE B
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7828
Mailing Address - Country:US
Mailing Address - Phone:513-398-3445
Mailing Address - Fax:513-398-4680
Practice Address - Street 1:7423 S MASON MONTGOMERY RD STE B
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7828
Practice Address - Country:US
Practice Address - Phone:513-398-3445
Practice Address - Fax:513-398-4680
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.149485207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program