Provider Demographics
NPI:1508884222
Name:GETZ, STANLEY B JR (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:B
Last Name:GETZ
Suffix:JR
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:PO BOX 602478
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2478
Mailing Address - Country:US
Mailing Address - Phone:704-446-6810
Mailing Address - Fax:704-376-0805
Practice Address - Street 1:1025 MOREHEAD MEDICAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2963
Practice Address - Country:US
Practice Address - Phone:704-446-6810
Practice Address - Fax:704-376-0805
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34322208200000X, 2082S0099X, 2086S0122X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1508884222Medicaid
NC3512XOtherNCBCBS
NC893512XMedicaid
SCN34322Medicaid
NC2198855DMedicare PIN
NCP00304979Medicare PIN
NC2198855FMedicare PIN
NC3512XOtherNCBCBS
NC893512XMedicaid
NC2198855EMedicare PIN