Individual
DR. GARY L STANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
24445 NORTHWESTERN HWY, SUITE 206, SOUTHFIELD, MI 48075-6501
(248) 799-0086
(248) 350-1178
Mailing address
24445 NORTHWESTERN HWY, SUITE 206, SOUTHFIELD, MI 48075-6501
(248) 799-0086
(248) 350-1178
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001470
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4856315900
BLUE CROSS BLUE SHIELD
MI
05
—
5184125
—
MI
Enumeration date
08/02/2006
Last updated
08/31/2012
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