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Individual

STANLEY E KOONTZ JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 HOSPITAL DR, SUITE # 1, NEW BERN, NC 28560-3410
(252) 633-8119
Mailing address
1174 COOL SPRINGS RD, ERNUL, NC 28527-9413
(252) 244-0729

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2006-01265
NC
207P00000X
Emergency Medicine Physician
35.086533
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0056419
OH
05
2583717
OH
Enumeration date
01/04/2006
Last updated
07/29/2019
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