Provider Demographics
NPI:1174637359
Name:STAMPFLI, GREG HOWARD (M D)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:HOWARD
Last Name:STAMPFLI
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5416 EDUCATION DR
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4094
Mailing Address - Country:US
Mailing Address - Phone:307-778-3675
Mailing Address - Fax:307-632-3302
Practice Address - Street 1:5416 EDUCATION DR
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4094
Practice Address - Country:US
Practice Address - Phone:307-778-3675
Practice Address - Fax:307-632-3302
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6298A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY308046OtherBCBS
WY080139715OtherRR MEDICARE
WY114339500Medicaid
WY080139715OtherRR MEDICARE
WY308046Medicare ID - Type Unspecified