Individual
CHARLES E. STANKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1658 ST VINCENTS WAY, #210, MIDDLEBURG, FL 32068-8446
(904) 214-8161
(904) 214-8164
Mailing address
11945 SAN JOSE BLVD, STE 300, JACKSONVILLE, FL 32223-1613
(904) 396-1725
(904) 399-1717
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME56957
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020039756
RAILROAD MEDICARE
FL
01
—
1705048
CIGNA
—
01
—
205862
AVMED
—
01
—
25097
BCBS FL
—
05
—
274937800
—
FL
01
—
5196465
AETNA
—
Enumeration date
05/04/2006
Last updated
11/16/2016
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