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Individual

DR. CHAD MICHAEL STINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3949 EVANS AVE STE 102, FORT MYERS, FL 33901-9341
(239) 939-2622
(239) 939-0151
Mailing address
10170 OAK HOLLOW CT, BONITA SPRINGS, FL 34135-7651
(850) 502-9946

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
TRN6689
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001690400
FL
01
1427224169
TRICARE
FL
01
1455G
BC/BS FL
FL
Enumeration date
11/21/2006
Last updated
10/13/2011
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