Individual
BONNIE STAMATIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5077 WATERFORD DR STE 305, SHEFFIELD VILLAGE, OH 44035-0705
(440) 365-4800
(440) 284-9909
Mailing address
5077 WATERFORD DR STE 305, SHEFFIELD VILLAGE, OH 44035-0705
(440) 365-4800
(440) 284-9909
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35064311
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141297
ANTHEM
OH
05
—
0908281
—
OH
01
—
110176964
RAILROAD MEDICARE
OH
01
—
341882027
COMMERCIAL CARRIERS
OH
01
—
36D0958263
CLIA
OH
Enumeration date
02/08/2006
Last updated
12/06/2022
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