Provider Demographics
NPI:1720027345
Name:HARVEY, STANLEY CHAD (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:CHAD
Last Name:HARVEY
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 1:900 E OCEAN BLVD
Mailing Address - Street 2:SUITE F150
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2471
Mailing Address - Country:US
Mailing Address - Phone:772-287-2191
Mailing Address - Fax:772-287-9808
Practice Address - Street 1:900 E OCEAN BLVD
Practice Address - Street 2:SUITE F150
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2471
Practice Address - Country:US
Practice Address - Phone:772-287-2191
Practice Address - Fax:772-287-9808
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055456207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
C16688Medicare UPIN
08911Medicare ID - Type Unspecified