Individual
DR. STANLEY TITANG TIBONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
30 E APPLE ST STE 5254A, DAYTON, OH 45409-2939
(937) 208-4200
Mailing address
6626 WOODLAND TRACE CT, LIBERTY TWP, OH 45044-9172
(513) 382-4927
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN. 344514
OH
363L00000X
Nurse Practitioner
Primary
APRN.CNP.15133
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094838
—
OH
Enumeration date
02/06/2010
Last updated
10/28/2016
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