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Individual

EDWARD SPIRES STANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 ARH LANE, SUITE 202B, LOW MOOR, VA 24457
(540) 862-7181
Mailing address
1 ARH LANE, SUITE 202B, LOW MOOR, VA 24457
(540) 862-7181

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101236472
VA
208600000X
Surgery Physician
061521
GA
208600000X
Surgery Physician
27858
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144201278
VA
01
79324
BLUE CROSS BLUE SHIELD
NC
05
8979324
NC
01
P00338174
RAILROAD MEDICARE
Enumeration date
11/07/2005
Last updated
09/28/2012
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