MEDICARE: MICHOL STANZIONE DO

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	207R00000X	Internal Medicine Physician	2006-01814	NC

General Provider Information

NPI Number	:	1396745881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHOL STANZIONE DO

Provider Business Mailing Address
First Line	:	205 PAGE ROAD
Second Line	:
City	:	PINEHURST
State	:	NC
Zip	:	28374-8798
Country	:	US
Telephone Number	:	910-295-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 MEDICAL PAVILION WAY
Second Line	:
City	:	SOUTHERN PINES
State	:	NC
Zip	:	28387-2224
Country	:	US
Telephone Number	:	910-246-4140
Fax Number	:	910-695-2192

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	09/15/2022

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