Provider Demographics
NPI:1104828094
Name:STANCOFSKI, ERIK D (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:D
Last Name:STANCOFSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 KINGS HWY
Mailing Address - Street 2:STE 103
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1772
Mailing Address - Country:US
Mailing Address - Phone:302-645-7050
Mailing Address - Fax:302-645-8473
Practice Address - Street 1:750 KINGS HWY
Practice Address - Street 2:STE 103
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1772
Practice Address - Country:US
Practice Address - Phone:302-645-7050
Practice Address - Fax:302-645-8473
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0005265208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000846001Medicaid
G00501Medicare ID - Type Unspecified
DE0000846001Medicaid