Provider Demographics
NPI:1972560746
Name:KRELL, STEPHEN P (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:KRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:85 OLD EAGLE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2544
Mailing Address - Country:US
Mailing Address - Phone:610-688-3744
Mailing Address - Fax:610-688-4490
Practice Address - Street 1:85 OLD EAGLE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:STRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:19087-2544
Practice Address - Country:US
Practice Address - Phone:610-688-3744
Practice Address - Fax:610-688-4490
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022996E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0030986000OtherKEYSTONE HEALTH PLAN EAST
PA71676OtherHIGHMARK BLUE SHIELD
PA71675OtherPERSONAL CHOICE
PA4088567OtherAETNA
PA71675OtherPERSONAL CHOICE
PA0030986000OtherKEYSTONE HEALTH PLAN EAST