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NPI Code Detail

MEDICARE: MICHAEL STOUT M.D.

MEDICARE: MICHAEL STOUT 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
1207Q00000XFamily Medicine PhysicianE1208AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1120616OTHERARUNITED HEALTHCARE
25K845OTHERARBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
418141000000OTHERARQUALCHOICE

General Provider Information

NPI Number : 1770576035
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL STOUT M.D.
Provider Business Mailing Address
First Line : 700 LILLY RD NE
Second Line :
City : OLYMPIA
State : WA
Zip : 98506-5115
Country : US
Telephone Number : 360-923-7000
Fax Number :
Provider Business Practice Location Address
First Line : 700 LILLY RD NE
Second Line :
City : OLYMPIA
State : WA
Zip : 98506-5115
Country : US
Telephone Number : 360-923-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 05/04/2021

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Directions to “ MICHAEL STOUT M.D.” Practice Location

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