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General NPI Number Information
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NPI Number | 1770571309
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Entity Type | Individual
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Provider Name | STEPHEN ROBERT STANLEY DO
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Gender | Male
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 320 E 8TH ST SUITE 142
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City | MARIETTA
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State | OH
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Zip | 45750-3382
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Country | US
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Telephone | 740-373-4111
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Fax | 740-373-4860
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Provider Business Mailing Address
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Address Line | PO BOX 449
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City | MARIETTA
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State | OH
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Zip | 45750-0449
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Country | US
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Telephone | 740-374-4500
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Fax | 740-374-5887
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 34.006980
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License Number State | OH
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