Individual
GRAHAM N STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2520 VALLEY DR, PLEASANT VALLEY HOSPITAL, POINT PLEASANT, WV 25550
(304) 674-2403
(304) 675-2240
Mailing address
PO BOX 711841, MID- ATLANTIC ANESTHESIA CONSULTANTS, COLUMBUS, OH 43271-0001
(304) 346-9400
(304) 720-8461
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
142485
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
22005
WV
367500000X
Certified Registered Nurse Anesthetist
NA00758
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706470
MSBCBS
WV
01
—
001721842
MSBCBS
WV
05
—
0067470000
—
WV
05
—
0207026000
—
WV
05
—
0752047
—
OH
01
—
2122544
ALLIANCE
WV
05
—
2460484
—
OH
01
—
27005299700
WORKERS COMP
WV
01
—
270052997003
TRICARE
WV
01
—
55075562100
BRICKSTREET
WV
01
—
DA0096
RR MEDICARE
WV
01
—
P00185907
RR MEDICARE
WV
Enumeration date
06/17/2006
Last updated
05/13/2008
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