Individual
EDWIN C STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSSAU, WI 54401-2121
(715) 847-2283
(484) 503-8200
Mailing address
BIN 88399, MILAWAUKEE, WI 53288-0399
(901) 448-1463
(901) 448-1465
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
51762-20
WI
2085R0202X
Diagnostic Radiology Physician
MD451105
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2007
Last updated
10/21/2019
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