Individual
JOHN MICHAEL STANAVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8901 WISCONSIN AVE, BETHESDA, MD 20889-0004
(301) 400-2838
Mailing address
8901 WISCONSIN AVE, BETHESDA, MD 20889-0004
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1710634175
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/06/2022
Last updated
08/28/2023
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