Healthcare Provider Details

I. General information

NPI: 1346968989
Provider Name (Legal Business Name): JOSEPH JAMES STANKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL PARK RD STE 402
COLUMBIA SC
29203-6839
US

IV. Provider business mailing address

425 N OKLAHOMA AVE APT 1109
OKLAHOMA CITY OK
73104-1829
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-8090
  • Fax:
Mailing address:
  • Phone: 214-277-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL96950
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: