Provider Demographics
NPI:1053507285
Name:STOFFEL, DEBORAH SUZANNE (DOM)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUZANNE
Last Name:STOFFEL
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:SUZI
Other - Middle Name:
Other - Last Name:STOFFEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DOM
Mailing Address - Street 1:S31W24757 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-7014
Mailing Address - Country:US
Mailing Address - Phone:262-547-2250
Mailing Address - Fax:262-547-2775
Practice Address - Street 1:2577 N 69TH ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-1315
Practice Address - Country:US
Practice Address - Phone:414-702-8163
Practice Address - Fax:414-727-5409
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI457-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist