Individual
MELVIN STANAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 454-2613
(803) 765-1732
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 765-1838
(803) 765-1732
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1043
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000166668
UNISON
SC
01
—
20018620
FIRST CHOICE
SC
01
—
576008010006
BLUE CHOICE
SC
01
—
576008010009
BCBS
DE
01
—
576008010015
TRICARE
SC
05
—
AN0006
—
SC
Enumeration date
04/19/2006
Last updated
04/28/2008
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