Provider Demographics
NPI:1538153523
Name:STYLE, STUART D (DO)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:D
Last Name:STYLE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1 BRITTON PL
Mailing Address - Street 2:SUITE 12
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2514
Mailing Address - Country:US
Mailing Address - Phone:856-772-1880
Mailing Address - Fax:856-770-0718
Practice Address - Street 1:1 BRITTON PL
Practice Address - Street 2:SUITE 12
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2514
Practice Address - Country:US
Practice Address - Phone:856-772-1880
Practice Address - Fax:856-770-0718
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2021-01-20
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Provider Licenses
StateLicense IDTaxonomies
PAOS007461L207Q00000X
NJMB56983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6310401Medicaid
ST466114Medicare ID - Type Unspecified
G19729Medicare UPIN