Individual
DR. MICHAEL EDWARD STOUT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
30 STONERIDGE DRIVE, SUITE 102, WAYNESBORO, VA 22980
(540) 949-8053
(540) 943-2505
Mailing address
30 STONERIDGE DRIVE, SUITE 102, WAYNESBORO, VA 22980
(540) 949-8053
(540) 943-2505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
VA0401007125
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
317947
ANTHEM BCBS
VA
05
—
7801114
—
VA
Enumeration date
05/23/2006
Last updated
07/08/2007
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