Healthcare Provider Details

I. General information

NPI: 1841494051
Provider Name (Legal Business Name): VLAD VASILE STANILA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 05/19/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 JOHN PAUL JONES CIRC
FPO AP
23701
US

IV. Provider business mailing address

PSC 482
FPO AP
96362
US

V. Phone/Fax

Practice location:
  • Phone: 757-314-0556
  • Fax:
Mailing address:
  • Phone: 315-646-9620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number57206-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number5720620
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: