Provider Demographics
NPI:1396118543
Name:STILLPOINT OSTEOPATHIC MEDICINE
Entity type:Organization
Organization Name:STILLPOINT OSTEOPATHIC MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:FRIED
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:217-480-0448
Mailing Address - Street 1:1999 S MAIN ST
Mailing Address - Street 2:SUITE 305-A
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6634
Mailing Address - Country:US
Mailing Address - Phone:540-552-2302
Mailing Address - Fax:540-552-2350
Practice Address - Street 1:1999 S MAIN ST
Practice Address - Street 2:SUITE 305-A
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6634
Practice Address - Country:US
Practice Address - Phone:540-552-2302
Practice Address - Fax:540-552-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102204075261QM2500X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty