Individual
DR. MICHAEL O STODARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1208 US HIGHWAY 98, DAPHNE, AL 36526-4254
(251) 626-5377
Mailing address
1208 US HIGHWAY 98, DAPHNE, AL 36526-4254
(251) 626-5377
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
09655
MS
207Q00000X
Family Medicine Physician
Primary
MD34796
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015240
—
MS
05
—
009965870
—
AL
01
—
730-13088
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/17/2006
Last updated
03/04/2020
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