Provider Demographics
NPI:1902392616
Name:STILLWATER MEDICINE LLP
Entity Type:Organization
Organization Name:STILLWATER MEDICINE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-699-2237
Mailing Address - Street 1:36 AUBURNDALE DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-9519
Mailing Address - Country:US
Mailing Address - Phone:859-699-2237
Mailing Address - Fax:
Practice Address - Street 1:300 MADISON AVE STE 1600
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-2633
Practice Address - Country:US
Practice Address - Phone:859-699-2237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center