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Organization

STANLY NEUROLOGY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID WILLIAM SCHMIDT M.D. (PRESIDENT)
(704) 982-0122
Entity
Organization

Contact information

Practice address
923 N 2ND ST, STE 102, ALBEMARLE, NC 28001-3369
(704) 982-0122
(704) 982-0125
Mailing address
923 N 2ND ST, STE 102, ALBEMARLE, NC 28001-3369
(704) 982-0122
(704) 982-0125

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
99-00131
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046373
MCKESSON SUBMITTER NUMBER
NC
01
1185T
BLUE CROSS PROVIDER #
NC
01
2318699
MEDICARE GROUP PTAN
NC
05
891185T
NC
01
99-00131
NC MEDICAL LICENSE NUMBER
NC
01
P00071547
RETIRED RAILROAD NUMBER
NC
Enumeration date
06/24/2006
Last updated
06/08/2009
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