Organization
STEPHEN R STANLEY DO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN R STANLEY D.O. (PRESIDENT)
(304) 422-6800
Entity
Organization
Contact information
Practice address
1500 GRAND CENTRAL AVE, SUITE 106, VIENNA, WV 26105-1079
(304) 422-6800
(304) 422-6900
Mailing address
1500 GRAND CENTRAL AVE, SUITE 106, VIENNA, WV 26105-1079
(304) 422-6800
(304) 422-6900
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1692
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2154225
—
OH
05
—
5630128000
—
WV
Enumeration date
10/22/2010
Last updated
04/20/2017
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