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Individual

DR. CHARLES A STONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3601 SW 160TH AVE, SUITE #250, MIRAMAR, FL 33027-6308
(305) 866-9951
(877) 284-8933
Mailing address
PO BOX 428, KNOX, IN 46534-0428
(574) 772-1270
(574) 772-7188

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01058806A
IN
208600000X
Surgery Physician
01058806
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000531495
ANTHEM
IN
05
200471390
IN
Enumeration date
09/01/2005
Last updated
03/02/2011
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