MEDICARE: MICHAEL G STANLEY D.O.

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
1	207R00000X	Internal Medicine Physician	222095	NY

General Provider Information

NPI Number	:	1669449021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL G STANLEY D.O.

Provider Business Mailing Address
First Line	:	CMR 480
Second Line	:	BOX 2559
City	:	APO
State	:	AE
Zip	:	09128
Country	:	DE
Telephone Number	:	497116808385
Fax Number	:

Provider Business Practice Location Address
First Line	:	CMR 480
Second Line	:	BOX 2559
City	:	APO
State	:	AE
Zip	:	09128
Country	:	DE
Telephone Number	:	497116808385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	07/21/2022

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