Provider Demographics
NPI:1164299814
Name:STAMEY, MAX S II
Entity Type:Individual
Prefix:MR
First Name:MAX
Middle Name:S
Last Name:STAMEY
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 ASHLAND ST APT B
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9033
Mailing Address - Country:US
Mailing Address - Phone:330-596-0596
Mailing Address - Fax:
Practice Address - Street 1:2108 ASHLAND ST APT B
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-9033
Practice Address - Country:US
Practice Address - Phone:330-596-0596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide