Provider Demographics
NPI:1710977764
Name:STANG, HOWARD D (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:D
Last Name:STANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:309 E FARWELL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-8202
Mailing Address - Country:US
Mailing Address - Phone:509-464-2873
Mailing Address - Fax:509-466-0914
Practice Address - Street 1:309 E FARWELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2225
Practice Address - Country:US
Practice Address - Phone:509-464-2873
Practice Address - Fax:509-466-0914
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00020536207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1019702Medicaid
WA37316OtherLABOR & INDUSTRIES
K4778OtherBLUE CROSS OF IDAHO
900000017OtherRAILROAD MEDICARE
00010008977OtherBLUE SHIELD OF IDAHO
4598STOtherASURIS NW HEALTH
ID003217400Medicaid
4021101OtherAETNA
ID003217400Medicaid
00010008977OtherBLUE SHIELD OF IDAHO