Individual
DOUGLAS L STANFORD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
432 KING DR, WATERLOO, IA 50702-5956
(319) 234-5764
(319) 234-1336
Mailing address
432 KING DR, WATERLOO, IA 50702-5956
(319) 234-5764
(319) 234-1336
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
21994
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0171140
—
IA
01
—
26938
WELLMARK
—
01
—
IA0114
JOHN DEERE HEALTH CARE
—
Enumeration date
07/07/2005
Last updated
07/08/2007
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