East Penn Dermatology, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

EAST PENN DERMATOLOGY, P.C.

Practice address

311 N Sumneytown Pike
Ste 1E
North Wales, PA 19454-2532

Phone

(215) 661-0300

Fax

(215) 661-0302

NPI assigned

Jun 23, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael B Stierstorfer, M.D.

Title

President

Phone

(215) 661-0300

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1942206925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N SUMNEYTOWN PIKE",
            "address_2": "STE 1E",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194542532",
            "telephone_number": "215-661-0300",
            "fax_number": "215-661-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N SUMNEYTOWN PIKE",
            "address_2": "STE 1E",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194542532",
            "telephone_number": "215-661-0300",
            "fax_number": "215-661-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PENN DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "STIERSTORFER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-661-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2230853",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "341275",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009001740001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in North Wales, PA
• Providers in North Wales, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.