Individual
STANLEY H STANCIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 275-1200
Mailing address
330 N WABASH AVE STE 475, MARION, IN 46952-2685
(765) 661-3522
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01060589A
IN
207L00000X
Anesthesiology Physician
4301081102
MI
207L00000X
Anesthesiology Physician
G0158
TX
2083A0100X
Aerospace Medicine Physician
4301081102
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01060589A
INDIANA
IN
01
—
05-0-41-1646-1
BCBS PIN
MI
01
—
050D110480
BCBS GROUP PIN
MI
01
—
081102SS
BCBS LICENSE
MI
01
—
4301081102
STATE LICENSE
MI
05
—
4913042
—
MI
01
—
M38730023
MEDICARE B
MI
01
—
P00403528
RAILROAD MEDICARE
MI
Enumeration date
06/28/2006
Last updated
07/24/2018
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