Organization
LINDA K STANLEY MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA K STANLEY MD (SOLE PROPRIETOR)
(269) 684-8100
Entity
Organization
Contact information
Practice address
9 S SAINT JOSEPH AVE, NILES, MI 49120-2846
(269) 684-8100
(269) 684-8261
Mailing address
9 S SAINT JOSEPH AVE, NILES, MI 49120-2846
(269) 684-8100
(269) 684-8261
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301043549
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0801106781
BCBS
MI
05
—
4409718
—
MI
Enumeration date
04/10/2007
Last updated
08/22/2020
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