Provider Demographics
NPI:1477732683
Name:STANG, ELLEN LOVE (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:LOVE
Last Name:STANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:450 PLYMOUTH ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462
Mailing Address - Country:US
Mailing Address - Phone:484-362-6520
Mailing Address - Fax:610-832-2010
Practice Address - Street 1:450 PLYMOUTH RD STE 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1647
Practice Address - Country:US
Practice Address - Phone:484-362-6520
Practice Address - Fax:610-832-2010
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD044770L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics