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Individual

MICHAEL STEWART STANLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
CAPE MAY USCG CLINIC, 1 MUNRO AVE, CAPE MAY, NJ 08204
(609) 898-6436
Mailing address
18 N VILLAGE DR, SOMERS POINT, NJ 08244-1221
(270) 404-0340

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00701300
NJ
363A00000X
Physician Assistant
PA581
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50073444
PASSPORT MANAGED MEDICAID
KY
05
9500251500
KY
Enumeration date
07/29/2005
Last updated
03/10/2023
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