Provider Demographics
NPI:1831794916
Name:STAMMEN, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:STAMMEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:BLANCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45107-8906
Mailing Address - Country:US
Mailing Address - Phone:937-725-0122
Mailing Address - Fax:
Practice Address - Street 1:105 FAWN LN
Practice Address - Street 2:
Practice Address - City:BLANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45107-8906
Practice Address - Country:US
Practice Address - Phone:937-725-0122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care