Provider Demographics
NPI:1225080831
Name:STAMATO, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:STAMATO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 6607
Mailing Address - Street 2:WYOMING ONCOLOGY
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-7101
Mailing Address - Country:US
Mailing Address - Phone:307-674-1566
Mailing Address - Fax:307-674-1566
Practice Address - Street 1:1585 W 5TH ST
Practice Address - Street 2:WELCH CANCER CENTER
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2703
Practice Address - Country:US
Practice Address - Phone:307-674-6022
Practice Address - Fax:307-672-9566
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR.00611922085R0001X
WY5816A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY111822600Medicaid
WY5816AOtherSTATE MEDICAL LICENSE
CO9000210504Medicaid