Provider Demographics
NPI:1952488389
Name:FOX, STANLEY LOWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:LOWELL
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:464 RICHMOND RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2792
Mailing Address - Country:US
Mailing Address - Phone:216-486-2233
Mailing Address - Fax:216-486-3175
Practice Address - Street 1:464 RICHMOND RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2792
Practice Address - Country:US
Practice Address - Phone:216-486-2233
Practice Address - Fax:216-486-3175
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35027438207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA71525Medicare UPIN