Provider Demographics
NPI:1346281409
Name:STANLEY, MERRILL (MD)
Entity Type:Individual
Prefix:
First Name:MERRILL
Middle Name:
Last Name:STANLEY
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 1:32 WICKS LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3810
Mailing Address - Country:US
Mailing Address - Phone:406-237-8300
Mailing Address - Fax:406-237-8301
Practice Address - Street 1:32 WICKS LN
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3810
Practice Address - Country:US
Practice Address - Phone:406-237-8300
Practice Address - Fax:406-237-8333
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9876207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine