Provider Demographics
NPI:1104197516
Name:PRINN K STANG MD
Entity Type:Organization
Organization Name:PRINN K STANG MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRINN
Authorized Official - Middle Name:
Authorized Official - Last Name:STANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-738-3220
Mailing Address - Street 1:99 E 86TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6267
Mailing Address - Country:US
Mailing Address - Phone:219-738-3220
Mailing Address - Fax:219-736-7164
Practice Address - Street 1:99 E 86TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6267
Practice Address - Country:US
Practice Address - Phone:219-738-3220
Practice Address - Fax:219-736-7164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-16
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01029174A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty