Provider Demographics
NPI:1619311834
Name:STANLEY, SHAUN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
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:SPHS CARE CENTER
Mailing Address - Street 2:75 E MAIDEN ST #100
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301
Mailing Address - Country:US
Mailing Address - Phone:724-228-2200
Mailing Address - Fax:
Practice Address - Street 1:MCSP
Practice Address - Street 2:4001 CA-104
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640
Practice Address - Country:US
Practice Address - Phone:304-881-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV265522084P0800X
PAMD4610552084P0800X
CAC1829432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry