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General NPI Number Information
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NPI Number | 1720067747
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Entity Type | Individual
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Provider Name | CHARLES A STANISLAV MD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 06/16/2011
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Provider Practice Location Address
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Address Line | 34435 KING STREET ROW SUITE 1
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City | LEWES
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State | DE
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Zip | 19958-4787
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Country | US
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Telephone | 302-644-1300
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Fax | 302-644-1086
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Provider Business Mailing Address
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Address Line | 34435 KING STREET ROW STE 1
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City | LEWES
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State | DE
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Zip | 19958-4787
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Country | US
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Telephone | 302-644-1300
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Fax | 302-644-1086
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C10005349
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | C100005349
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | C100005349
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License Number State | DE
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