Individual
ANGELINA STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5021 CRAIG RATH BLVD, MIDLOTHIAN, VA 23112-6243
(804) 592-5437
(804) 592-2406
Mailing address
825 FAIRFAX AVE, NORFOLK, VA 23507-1914
(757) 446-5600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110011067
VA
Other
Enumeration date
01/10/2025
Last updated
09/02/2025
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