Individual
MR. PHILLIP LOUIS STANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
11828 CANON BLVD, STE E, NEWPORT NEWS, VA 23606-2554
(757) 599-4922
Mailing address
814 CONSTANCE DR APT A, NEWPORT NEWS, VA 23601-1662
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110002323
VA
363A00000X
Physician Assistant
Primary
1692
TN
Other
Enumeration date
06/23/2006
Last updated
12/05/2019
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