Provider Demographics
NPI:1912919978
Name:STANTON, ROBERT A (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:STANTON
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 1:305 BLACK ROCK TPKE
Mailing Address - Street 2:ORTHOPAEDIC SPECIALTY GROUP
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-5508
Mailing Address - Country:US
Mailing Address - Phone:203-337-2600
Mailing Address - Fax:203-337-2666
Practice Address - Street 1:305 BLACK ROCK TPKE
Practice Address - Street 2:ORTHOPAEDIC SPECIALTY GROUP
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-5508
Practice Address - Country:US
Practice Address - Phone:203-337-2600
Practice Address - Fax:203-337-2666
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT017128207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TINOtherGREAT WEST
TINOtherORTHONET
TINOtherPIONEER
TINOtherPOMCO
CTZS306OtherOXFORD
CT000508OtherHEALTH NET
TINOtherNORTHEAST HEALTH DIRECT
TINOtherCORVEL
CT0085224OtherAETNA
TINOtherNEHCA HMC /PPO
CT010017128CT02OtherANTHEM BC/BS
CT329051 (2) (3)OtherEMPIRE
CT571289OtherCONNECTICARE
TINOtherFIRST HEALTH / CCN
CT001171289Medicaid
TINOtherCIGNA
TINOtherUNITED HEALTHCARE
TINOtherNATIONAL PROVIDER NETWORK
TINOtherORTHONET
TINOtherFIRST HEALTH / CCN