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General NPI Number Information
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NPI Number | 1588744882
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Entity Type | Organization
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Legal Business Name | TEHAN, NARDI & STANTON UROLOGY CENTER CHARTERED
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 10215 FERNWOOD RD STE 630
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City | BETHESDA
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State | MD
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Zip | 20817-1184
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Country | US
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Telephone | 301-493-2505
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Fax |
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Provider Business Mailing Address
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Address Line | 12 FAIRWAY IS
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City | GRASONVILLE
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State | MD
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Zip | 21638-9630
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Country | US
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Telephone | 410-827-9455
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Fax | 410-827-7161
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MICHAEL JOSEPH STANTON
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Credential | MD.
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Telephone | 301-493-2505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0022953
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License Number State | MD
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