Simon J Stillwaggon, is a
Massage Therapist based in Philadelphia, Pennsylvania. Simon J Stillwaggon is licensed to practice in Pennsylvania (license number MSG015461) and his current practice location is
3821 Baring St, Philadelphia, Pennsylvania. He can be reached at his office (for appointments etc.) via phone at
(609) 489-2074.
NPI number for Simon J Stillwaggon is 1710382486 and his current mailing address is 3821 Baring St, Philadelphia, Pennsylvania. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710382486.
Healthcare Provider's Profile
| Full Name | Simon J Stillwaggon |
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| Gender | Male |
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| Speciality | Massage Therapist |
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| Location | 3821 Baring St, Philadelphia, Pennsylvania |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1710382486
- Provider Enumeration Date: 10/23/2014
- Last Update Date: 04/29/2026
Medical Identifiers
Medical identifiers for Simon J Stillwaggon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1710382486 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 225700000X | Massage Therapist | MSG015461 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Simon J Stillwaggon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Simon J Stillwaggon, 3821 Baring St, Philadelphia, PA 19104-5580 Ph: () - | Simon J Stillwaggon, 3821 Baring St, Philadelphia, PA 19104-5580 Ph: (609) 489-2074 |
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