Provider Demographics
NPI:1447658927
Name:STOLLAR, SALLY ANN (PA-C)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:ANN
Last Name:STOLLAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:109 MOUNT WOOD RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2632
Mailing Address - Country:US
Mailing Address - Phone:304-233-2455
Mailing Address - Fax:304-233-6073
Practice Address - Street 1:46150 NATIONAL RD W
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8715
Practice Address - Country:US
Practice Address - Phone:740-695-2443
Practice Address - Fax:740-695-2511
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2023-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV01830363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical