Individual
JOHN R STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD, 1-330S PERELMAN CENTER, PHILADELPHIA, PA 19104-5127
(215) 662-2737
(215) 615-3424
Mailing address
421 CURIE BLVD, 100 BRB, PHILADELPHIA, PA 19104-4863
(215) 898-3240
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD054336L
PA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
MD054336L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00163494600Z
—
PA
Enumeration date
07/13/2006
Last updated
11/09/2015
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