Provider Demographics
NPI:1518932409
Name:ZAGORSKI, STANLEY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:MICHAEL
Last Name:ZAGORSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:1086 FRANKLIN ST
Practice Address - Street 2:GOOD SAMARITAN BUILDING, GROUND FLOOR
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4305
Practice Address - Country:US
Practice Address - Phone:814-539-8725
Practice Address - Fax:814-539-3906
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD 9257208600000X
PAMD452563208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000Medicare UPIN