Individual
MARCUS DUANE STANBRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 PATEWOOD DR STE B260, GREENVILLE, SC 29615-6328
(864) 454-2852
(864) 454-2899
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
662
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00802362
RR MEDICARE
SC
05
—
T00808
—
SC
Enumeration date
05/18/2006
Last updated
11/10/2022
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