Individual
MR. STANLEY R STANSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
397 LITTLE NECK RD STE 100, VIRGINIA BEACH, VA 23452-5764
(757) 470-5570
(757) 961-9359
Mailing address
397 LITTLE NECK RD STE 100, VIRGINIA BEACH, VA 23452-5764
(757) 470-5576
(757) 961-9359
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110001891
VA
363AS0400X
Surgical Physician Assistant
0101279
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00169884
RAILROAD MEDICARE
—
Enumeration date
10/26/2005
Last updated
12/17/2007
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