Healthcare Provider Details

I. General information

NPI: 1417790213
Provider Name (Legal Business Name): HIRED BLADE, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 LOST KEY DR UNIT 202A
PENSACOLA FL
32507-3681
US

IV. Provider business mailing address

616 LOST KEY DR UNIT 202A
PENSACOLA FL
32507-3681
US

V. Phone/Fax

Practice location:
  • Phone: 540-327-3311
  • Fax:
Mailing address:
  • Phone: 540-327-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARC DENTON STAM
Title or Position: OWNER
Credential: MD
Phone: 540-327-3311