Individual
ADAM D STANDIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(269) 321-1705
Mailing address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(269) 321-1705
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601009869
MI
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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