Provider Demographics
NPI:1538239603
Name:STOLLER, ROY B (DO)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:B
Last Name:STOLLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:222 SYKES LN
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6337
Mailing Address - Country:US
Mailing Address - Phone:610-357-8784
Mailing Address - Fax:610-459-0399
Practice Address - Street 1:100 RIDGE RD
Practice Address - Street 2:SUITE 12
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9784
Practice Address - Country:US
Practice Address - Phone:610-459-3001
Practice Address - Fax:610-459-0399
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006048E207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery