Provider Demographics
NPI:1174568679
Name:TRAGER, STUART L (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:L
Last Name:TRAGER
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 1:301 S 8TH ST STE 2C
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4017
Mailing Address - Country:US
Mailing Address - Phone:215-829-7444
Mailing Address - Fax:215-829-7674
Practice Address - Street 1:301 S 8TH ST STE 2C
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-4017
Practice Address - Country:US
Practice Address - Phone:215-829-7444
Practice Address - Fax:215-829-7674
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08177200207X00000X
PAMD047881L207XS0106X
PAMD-047881-L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF32965Medicare UPIN
PA038474Medicare ID - Type Unspecified