Provider Demographics
NPI:1578581724
Name:STANGLER, DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:STANGLER
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 1:36 OLD KINGS HWY S
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4523
Mailing Address - Country:US
Mailing Address - Phone:203-767-2496
Mailing Address - Fax:
Practice Address - Street 1:36 OLD KINGS HWY S
Practice Address - Street 2:SUITE 210
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4523
Practice Address - Country:US
Practice Address - Phone:203-767-2496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22225207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001222256Medicaid
CT001222256Medicaid
CT110006798Medicare ID - Type Unspecified