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NPI Code Detail

MEDICARE: DR. JOHN L. STANLEY MD

MEDICARE: DR. JOHN L. STANLEY 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
1207Q00000XFamily Medicine Physician70472MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1070472OTHERMATUFTS HEALTH PLAN
270257OTHERMAHARVARD PILGRIM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4J30154OTHERMABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1063499051
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN L. STANLEY MD
Provider Business Mailing Address
First Line : 28 RIVERSIDE DR
Second Line :
City : PEMBROKE
State : MA
Zip : 02359-1937
Country : US
Telephone Number : 781-826-8065
Fax Number : 781-826-8043
Provider Business Practice Location Address
First Line : 28 RIVERSIDE DR
Second Line :
City : PEMBROKE
State : MA
Zip : 02359-1937
Country : US
Telephone Number : 781-826-8065
Fax Number : 781-826-8043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 02/22/2008

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Directions to “ DR. JOHN L. STANLEY MD” Practice Location

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