Basic Information
| Provider Information | |||||||||
| NPI: | 1396745881 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STANZIONE | ||||||||
| FirstName: | MICHOL | ||||||||
| MiddleName: | |||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 205 PAGE ROAD | ||||||||
| Address2: | |||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283748798 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102955511 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 200 MEDICAL PAVILION WAY | ||||||||
| Address2: | |||||||||
| City: | SOUTHERN PINES | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283872224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102464140 | ||||||||
| FaxNumber: | 9106952192 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2005 | ||||||||
| LastUpdateDate: | 09/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2006-01814 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.