Provider Demographics
NPI:1811286834
Name:STANTON, MONICA WILLIAMS (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:WILLIAMS
Last Name:STANTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LEIGH
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 LIVELY OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-6106
Mailing Address - Country:US
Mailing Address - Phone:703-217-9582
Mailing Address - Fax:
Practice Address - Street 1:15854 JACKSON CREEK PKWY UNIT 120
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8663
Practice Address - Country:US
Practice Address - Phone:719-364-9930
Practice Address - Fax:719-364-9939
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0065013207R00000X
390200000X
NC2014-00788207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program