Individual
MR. STANLEY R STANSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
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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