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Individual

DR. STANTON MAURICE REGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01073669A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000876441
ANTHEM PROVIDER NUMBER
IN
05
201226370
IN
Enumeration date
04/03/2008
Last updated
02/19/2021
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