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NPI Code Detail

MEDICARE: DR. MARK W STANFORD MD

MEDICARE: DR. MARK W STANFORD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician35085500SOH

General Provider Information

NPI Number : 1003897059
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK W STANFORD MD
Provider Business Mailing Address
First Line : 300 PINELLAS ST
Second Line : MS 36
City : CLEARWATER
State : FL
Zip : 33756-3804
Country : US
Telephone Number : 727-298-6612
Fax Number : 727-447-7175
Provider Business Practice Location Address
First Line : 300 PINELLAS ST
Second Line : MORTON PLANT HOSPITAL
City : CLEARWATER
State : FL
Zip : 33756-3804
Country : US
Telephone Number : 727-462-7000
Fax Number : 727-447-7175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 08/26/2009

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