MEDICARE: MICHAEL D STONE M.D.

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	208600000X	Surgery Physician	052372	CT
2	2086X0206X	Surgical Oncology Physician	052372	CT

General Provider Information

NPI Number	:	1356300859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D STONE M.D.

Provider Business Mailing Address
First Line	:	1351 WASHINGTON BLVD
Second Line	:	6TH FLOOR
City	:	STAMFORD
State	:	CT
Zip	:	06902-2419
Country	:	US
Telephone Number	:	203-276-5959
Fax Number	:	203-576-5969

Provider Business Practice Location Address
First Line	:	1351 WASHINGTON BLVD
Second Line	:	6TH FLOOR
City	:	STAMFORD
State	:	CT
Zip	:	06902-2419
Country	:	US
Telephone Number	:	203-276-5959
Fax Number	:	203-576-5969

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	10/08/2013

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