Provider Demographics
NPI:1962473843
Name:STAS, MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:STAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:SUITE 508
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3245
Practice Address - Country:US
Practice Address - Phone:703-971-7633
Practice Address - Fax:703-971-2219
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101057336207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G72972Medicare UPIN