Stanford, Douglas L

Stanford, Douglas L is an individual health care provider with primary practice located at 432 King Dr , Waterloo IA 50702-5956. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Stanford, Douglas L can be contacted via phone (319) 234-5764.

Contact Information

Primary practice address
432 King Dr Waterloo IA 50702-5956
Phone: (319) 234-5764
Fax: (319) 234-1336
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 21994 Iowa

Profile Details

NPI number 1811995517
LBN Legal business name Stanford, Douglas L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811995517 NPPES
Iowa MEDICAID 0171140
Iowa Other IA0114
Iowa Other 26938

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