Individual
BRIAN JOHN STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
110 REHILL AVENUE, SOMERVILLE, NJ 08876
(908) 685-2935
(908) 704-3756
Mailing address
176 FEATHERBED LANE, FLEMINGTON, NJ 08822
(908) 237-1442
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MB06394900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7363401
—
NJ
Enumeration date
09/20/2006
Last updated
07/08/2007
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