Provider Demographics
NPI:1700997699
Name:STOLMAN, KAREN R (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:STOLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 575
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-0575
Mailing Address - Country:US
Mailing Address - Phone:406-439-0607
Mailing Address - Fax:406-443-2380
Practice Address - Street 1:1790 SUN PEAK DR STE A103
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-6625
Practice Address - Country:US
Practice Address - Phone:435-658-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT52163981205207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005542347Medicare PIN