MEDICARE: MR. MARK C STANOS JR. DPM

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	213E00000X	Podiatrist	36003256S	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PO0359999	OTHER	OH	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730102930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK C STANOS JR. DPM

Provider Business Mailing Address
First Line	:	3255 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-1923
Country	:	US
Telephone Number	:	614-239-0399
Fax Number	:

Provider Business Practice Location Address
First Line	:	3255 E. LIVINGSTON AVENUE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-4322
Country	:	US
Telephone Number	:	614-239-9444
Fax Number	:	614-239-1080

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	08/17/2021

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Directions to “ MR. MARK C STANOS JR. DPM” Practice Location

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