Provider Demographics
NPI:1871586644
Name:STOFFA, ROBERT J (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:STOFFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-0384
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1331
Practice Address - Country:US
Practice Address - Phone:814-467-3653
Practice Address - Fax:814-467-3655
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6P98207RG0100X
PAMD474106207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO124510097Medicare PIN