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NPI Code Detail

MEDICARE: TINA MARIE STANLEY R.T.

MEDICARE: TINA MARIE STANLEY R.T.
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
1247100000XRadiologic Technologist411530CA
22471C3402XRadiography Radiologic Technologist411530CA

General Provider Information

NPI Number : 1912163510
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA MARIE STANLEY R.T.
Provider Business Mailing Address
First Line : 103B EGRET LANDING CT
Second Line :
City : SURF CITY
State : NC
Zip : 28445-9410
Country : US
Telephone Number : 858-254-3330
Fax Number :
Provider Business Practice Location Address
First Line : 103B EGRET LANDING CT
Second Line :
City : SURF CITY
State : NC
Zip : 28445-9410
Country : US
Telephone Number : 858-254-3330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2008
Last Update Date : 08/03/2008

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Directions to “ TINA MARIE STANLEY R.T.” Practice Location

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