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Individual

ANTHONY STALLION

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3535 W 13 MILE RD STE 307, ROYAL OAK, MI 48073-6770
(248) 551-2400
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-4352

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
2013-01542
NC
2086S0120X
Pediatric Surgery Physician
35060022S
OH
2086S0120X
Pediatric Surgery Physician
Primary
4301063442
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0803198
OH
05
1265499206
NC
05
Q0154E
SC
Enumeration date
04/26/2006
Last updated
10/31/2024
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