Individual
DR. MICHAEL STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, MS
Contact information
Practice address
405 W JACKSON STREET, DBA SIH MEDICAL GROUP ANESTHESIOLOGY, CARBONDALE, IL 62901
(618) 549-0721
(618) 529-0449
Mailing address
405 W JACKSON STREET, DBA SIH MEDICAL GROUP ANESTHESIOLOGY, CARBONDALE, IL 62901
(618) 549-0721
(618) 529-0449
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036146722
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214881
MULTI-SPECIALTY GROUP PTAN
IL
Enumeration date
07/25/2013
Last updated
11/18/2019
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