MEDICARE: SCOTT ALAN STANAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	571	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00408069	OTHER	SC	RAILROOAD MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00179666	OTHER	SC	RAILROAD PROVIDER NUMBER
3	187353	OTHER	SC	MEDCOST PROVIDER NUMBER

General Provider Information

NPI Number	:	1083643639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT ALAN STANAS

Provider Business Mailing Address
First Line	:	39 HOSPITAL CENTER CMNS
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-2837
Country	:	US
Telephone Number	:	843-689-2233
Fax Number	:	843-689-2234

Provider Business Practice Location Address
First Line	:	39 HOSPITAL CENTER CMNS
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-2837
Country	:	US
Telephone Number	:	843-689-2233
Fax Number	:	843-689-2234

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	01/21/2021

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Directions to “ SCOTT ALAN STANAS ” Practice Location

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