Healthcare Provider Details

I. General information

NPI: 1003005257
Provider Name (Legal Business Name): STANLEY CARTER PACE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7580 AUBURN RD #302, C/O DRS. HILL AND CHAPNICK, INC
CONCORD TWP OH
44077-9615
US

IV. Provider business mailing address

659 BOULEVARD ST
DOVER OH
44622-2026
US

V. Phone/Fax

Practice location:
  • Phone: 440-354-4208
  • Fax:
Mailing address:
  • Phone: 330-343-3311
  • Fax: 330-364-0955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number094437
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number094437
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: