Provider Demographics
NPI:1811106669
Name:SOLITRO, TAMARA STOLZ (MD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:STOLZ
Last Name:SOLITRO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:443 LAUREL OAK ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4451
Mailing Address - Country:US
Mailing Address - Phone:856-784-7398
Mailing Address - Fax:856-784-7357
Practice Address - Street 1:443 LAUREL OAK ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4451
Practice Address - Country:US
Practice Address - Phone:856-784-7398
Practice Address - Fax:856-784-7357
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2013-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT188742207R00000X
NJ25MA08637000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0215759Medicaid
NJ168684DLUMedicare UPIN