ETHAN D STOLZENBERG (NPI# 1164434585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164434585 |
| Entity Type | Individual |
| Full Name | ETHAN D STOLZENBERG |
| Credential | MD |
| Practice Address |
940 Stanton L Young Blvd Suite 451 Oklahoma City OK 73104-5020 |
| Mailing Address |
1122 Ne 13th St Ori 236 Oklahoma City OK 73117-1039 |
| Practice Telephone | 4052712422 |
| Mailing Telephone | 4052711515 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207ZN0500X |
Pathology Specialization: Neuropathology |
25244 | OK | Allopathic & Osteopathic Physicians |
| X | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
25244 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
940 STANTON L YOUNG BLVD SUITE 451 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73104-5020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972572881 | Kar-ming A Fung | Pathology | 940 Stanton L Young Blvd, Ste. 451, Oklahoma City, OK 73104-5020 | 2006-03-14 |
| 1104435866 | Cody Andrew Cox | Pathology | 940 Stanton L Young Blvd, Oklahoma City, OK 73104-5020 | 2020-07-29 |
| 1275192940 | Jordan Taylor Keith | Student in an Organized Health Care Education/Training Program | 940 Stanton L Young Blvd, Oklahoma City, OK 73104-5020 | 2019-06-06 |
| 1154980837 | Beth Raju | Student in an Organized Health Care Education/Training Program | 940 Stanton L Young Blvd, Oklahoma City, OK 73104-5020 | 2019-06-06 |
| 1982197521 | Manuel Maldonado-vital | Student in an Organized Health Care Education/Training Program | 940 Stanton L Young Blvd, Bmsb 451, Oklahoma City, KS 73104 | 2018-06-08 |
| 1447771019 | Carlos Rodrigo Dominguez | Student in an Organized Health Care Education/Training Program | 940 Stanton L Young Blvd, Oklahoma City, OK 73104-5020 | 2017-07-04 |
| 1043668130 | Sifat Kibria | Student in an Organized Health Care Education/Training Program | 940 Stanton L Young Blvd, Oklahoma City, OK 73104-5020 | 2016-05-30 |
| 1790131738 | Greeballa Magzoub | Student in an Organized Health Care Education/Training Program | 940 Stanton L Young Blvd, Bmsb 451, Oklahoma City, OK 73104-5020 | 2016-05-09 |
| 1639554181 | Shahbaz Ali Khan | Pathology | 940 Stanton L Young Blvd, Bmsb 451, Oklahoma City, OK 73104-5020 | 2015-07-27 |
| 1851706220 | Ngoc Thy Bao Tran | Pathology | 940 Stanton L Young Blvd, Bmsb 451, Oklahoma City, OK 73104-5020 | 2014-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356979645 | Kayla Campbell | Dietitian, Registered | Stephenson Cancer Center, 800 Ne 10th Street, Oklahoma City, OK 73104 | 2020-03-31 |
| 1447715453 | Roman Michael Garcia | Dentist | Ou Children's Physicians - Dental Clinic, 1200 Children's Ave, 8f, Oklahoma City, OK 73104 | 2019-02-04 |
| 1265902340 | Jenna Lyn Celii | Registered Nurse | 920 Sl Young Blvd Ste 1140, Oklahoma City, OK 73104 | 2018-11-30 |
| 1407337462 | Opus Medical, LLC | Psychiatry & Neurology | 4 Ne 10th St Suite 467, Oklahoma City, OK 73104 | 2018-08-27 |
| 1316433295 | Syed Muhammad Shakaib Quadri | Pathology | 940 Stanton L. Young Blvd., Bmsb 451, Oklahoma City, OK 73104 | 2018-07-03 |
| 1447746417 | Nimrah Bader | Internal Medicine | 800 Stanton L. Young Blvd., Aat 6300, Oklahoma City, OK 73104 | 2018-07-02 |
| 1417440793 | Helen Judith Turkson Apetor | Nurse Practitioner | 700 Ne 13th, Oklahoma City, OK 73104 | 2018-06-11 |
| 1003307935 | Mary Katlin Nixon | Obstetrics & Gynecology | 800 Stanton L Young Blvd Ste 2319, Oklahoma City, OK 73104 | 2018-05-26 |
| 1558851220 | Bryce Yohannan | Student in an Organized Health Care Education/Training Program | 800 Stanton L Young Blvd, Aat 6300, Oklahoma City, OK 73104 | 2018-05-17 |
| 1346746690 | Kacy Anne Richburg | Orthopaedic Surgery | 711 Stanton L Young Blvd Ste 111, Oklahoma City, OK 73104 | 2018-04-04 |
| Find all providers in zip 73104 | ||||
| Taxonomy Code | 207ZN0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Neuropathology |
| A neuropathologist is expert in the diagnosis of diseases of the nervous system and skeletal muscles and functions as a consultant primarily to neurologists and neurosurgeons. The neuropathologist is knowledgeable in the infirmities of humans as they affect the nervous and neuromuscular systems, be they degenerative, infectious, metabolic, immunologic, neoplastic, vascular or physical in nature. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pathology. The Certification is NO longer provided. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972572881 | Kar-ming A Fung | Pathology | 940 Stanton L Young Blvd, Ste. 451, Oklahoma City, OK 73104-5020 | 2006-03-14 |
| 1881830438 | Jo Elle Grace Peterson | Pathology | 940 Stanton L Young Blvd # 451, Oklahoma City, OK 73104-5020 | 2009-01-05 |
| City | OKLAHOMA CITY |
| Zip Code | 73104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.