Provider Demographics
NPI:1003908963
Name:STANTON CARDIOLOGY CENTER, PLLC
Entity Type:Organization
Organization Name:STANTON CARDIOLOGY CENTER, PLLC
Other - Org Name:H. JAMES STANTON, MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-926-8080
Mailing Address - Street 1:4315 MACCORKLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2503
Mailing Address - Country:US
Mailing Address - Phone:304-926-8080
Mailing Address - Fax:304-926-8083
Practice Address - Street 1:4315 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2503
Practice Address - Country:US
Practice Address - Phone:304-926-8080
Practice Address - Fax:304-926-8083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12013207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVDA4088OtherRAILROAD MEDICARE
WV0087346001Medicaid
WV9930301Medicare PIN