Individual
ILYA STONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-7050
(573) 458-8399
Mailing address
14275 MIDWAY RD STE 400, ADDISON, TX 75001-3661
(206) 622-7747
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD00038295
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0189042
WA ST LABOR & INDUSTRIES
—
01
—
0189063
WA ST LABOR & INDUSTRIES
—
05
—
8248676
—
WA
Enumeration date
11/15/2005
Last updated
06/06/2025
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