Provider Demographics
NPI:1134103054
Name:STONER, MICHAEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:STONER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 652
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-8410
Mailing Address - Country:US
Mailing Address - Phone:585-279-5100
Mailing Address - Fax:585-756-7752
Practice Address - Street 1:200 WHITE SPRUCE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1605
Practice Address - Country:US
Practice Address - Phone:585-279-5100
Practice Address - Fax:585-756-7752
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2724702086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03718696Medicaid
NYJ400100461Medicare PIN
NCI38843Medicare UPIN
NCI38843Medicare UPIN
NC2044901Medicare PIN