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Individual
MICHAEL STEWART STANLEY
Active
Individual
MICHAEL STEWART STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00701300
NJ
363A00000X
Physician Assistant
PA581
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50073444
PASSPORT MANAGED MEDICAID
KY
05
—
9500251500
—
KY
Enumeration date
07/29/2005
Last updated
03/10/2023
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