Individual
MR. PETER MALCOLM STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
316 RAILROAD AVE, GOLDSBORO, MD 21636-1126
(410) 634-2380
(410) 482-7488
Mailing address
301 RANDOLPH ST, DENTON, MD 21629-1243
(410) 479-4306
(410) 479-1714
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C04049
MD
Other
Enumeration date
02/02/2013
Last updated
10/19/2015
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