Individual
DR. JEFFREY D STANCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3623 LATROBE DR STE 216, CHARLOTTE, NC 28211
(704) 332-1291
Mailing address
PO BOX 221249, CHARLOTTE, NC 28222-1249
(704) 332-1291
(704) 332-5206
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101234039
VA
2085R0202X
Diagnostic Radiology Physician
Primary
2010-00985
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010069009
—
VA
01
—
P00106044
RRMED
VA
Enumeration date
02/07/2006
Last updated
12/03/2024
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