Organization
STANFORD UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCY KULAKOW (REGISTRAR STANFORD GME)
(650) 723-5948
Entity
Organization
Contact information
Practice address
401 QUARRY RD, STANFORD, CA 94305
(847) 644-0786
Mailing address
2515 KEMPER RD, APT 510, SHAKER HEIGHTS, OH 44120-5500
(847) 644-0786
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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