Provider Demographics
NPI:1497974380
Name:STALLINGS, GARY WAYNE II (MD, MPH)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:WAYNE
Last Name:STALLINGS
Suffix:II
Gender:M
Credentials:MD, MPH
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:95 GRASSLANDS RD
Mailing Address - Street 2:DEPT. OF MEDICINE-MUNGER PAVILION
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1652
Mailing Address - Country:US
Mailing Address - Phone:914-493-8370
Mailing Address - Fax:914-594-4434
Practice Address - Street 1:95 GRASSLANDS RD
Practice Address - Street 2:DEPT. OF MEDICINE-MUNGER PAVILION
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1652
Practice Address - Country:US
Practice Address - Phone:914-493-8370
Practice Address - Fax:914-594-4434
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.200358207R00000X
NY248087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine