Individual
GARY E STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
031831
CT
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
031831
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001318311
—
CT
Enumeration date
11/29/2005
Last updated
07/27/2009
Update your record
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