Individual
DR. ANATOL J STANKEVYCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
923 ELIZA ST, GREEN BAY, WI 54301-3234
(920) 965-4800
(920) 431-7024
Mailing address
923 ELIZA ST, GREEN BAY, WI 54301
(920) 965-4800
(920) 431-7024
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23258
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000107100
MEDICARE PTAN
WI
05
—
30341500
—
WI
Enumeration date
02/20/2007
Last updated
08/10/2016
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