Individual
STANEY ARUL SELVAN JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 NORTH OAK AVE, MED PEDS OFFICE 1F, MARSHFIELD, WI 54449
(715) 389-3554
Mailing address
1000 NORTH OAK AVE, MED PEDS OFFICE 1F, MARSHFIELD, WI 54449
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
100047-851
WI
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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