MEDICARE: MICHAEL D. STAMBAUGH MD

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	2085R0001X	Radiation Oncology Physician	25MA06318300	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29882	OTHER	NJ	UNIV. HLTH PL. PROVIDER #
2	2K7309	OTHER	NJ	HEALTH NET PROVIDER #
3	3644795	OTHER	NJ	AETNA PROVIDER NUMBER
4	4099456	OTHER	NJ	GHI PROVIDER NUMBER
5	65068	OTHER	NJ	AMERIGROUP PROVIDER #
6	P00179698	OTHER	NJ	RAILROAD MCARE PROV. #
7	P2364047	OTHER	NJ	OXFORD HEALTH PROV. #
8	0268865000	OTHER	NJ	AMERIHEALTH PROVIDER #
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	01000343204	OTHER	NJ	AMERICHOICE-WILLINGBORO #
11	01000343202	OTHER	NJ	AMERICHOICE - VORHEES #
12	01000343203	OTHER	NJ	AMERICHOICE - WOODBURY #
13	60016956	OTHER	NJ	HORIZON NJ HEALTH PROV. #
14	3774564	OTHER	NJ	CIGNA PROVIDER NUMBER

General Provider Information

NPI Number	:	1407841190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D. STAMBAUGH MD

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	17 W RED BANK AVE
Second Line	:	SUITE 105
City	:	WOODBURY
State	:	NJ
Zip	:	08096-1630
Country	:	US
Telephone Number	:	856-848-7374
Fax Number	:	856-848-5855

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	07/08/2007

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