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General NPI Number Information
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NPI Number | 1932359882
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Entity Type | Organization
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Legal Business Name | ANN E STANGER MD LLC
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 04/29/2013
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Provider Practice Location Address
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Address Line | 2984 TRIVERTON PIKE DR
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City | FITCHBURG
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State | WI
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Zip | 53711-5841
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Country | US
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Telephone | 608-233-2378
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Fax | 608-233-2375
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Provider Business Mailing Address
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Address Line | 2984 TRIVETON PIKE DRIVE
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City | FITCHBURG
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State | WI
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Zip | 53711-6428
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Country | US
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Telephone | 608-233-2378
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Fax | 608-233-2375
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Authorized Official
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Title or Position | OWNER
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Name | ANN E STANGER
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Credential | M.D.
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Telephone | 608-233-2378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 31332
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License Number State | WI
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