Individual
JASON CHARLES STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
19466 CARAVAN DR, GERMANTOWN, MD 20874-6220
(214) 227-2457
(214) 764-0880
Mailing address
8110 MAPLE LAWN BLVD STE 235, FULTON, MD 20759-2694
(301) 340-8339
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0002208
MD
Other
Enumeration date
01/25/2008
Last updated
12/01/2023
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