Individual
PERI R STANGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6301 UNIVERSITY COMMONS STE 210, SOUTH BEND, IN 46635-1590
(574) 234-4016
(574) 239-4607
Mailing address
6301 UNIVERSITY COMMONS STE 210, SOUTH BEND, IN 46635-1590
(574) 234-4016
(574) 239-4607
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10002615A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300021948
—
IN
Enumeration date
11/06/2018
Last updated
06/04/2024
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