Individual
DR. STANLEY MICHAEL STANISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 WYOMING AVE, KINGSTON, PA 18704-3831
(570) 288-4205
Mailing address
675 WYOMING AVE, KINGSTON, PA 18704-3831
(570) 288-4205
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD039841-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01026932
—
PA
Enumeration date
02/01/2007
Last updated
09/17/2010
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