Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 4301027991 | MI |
NPI | 1194885459 |
---|---|
Provider Name | Dr. James Bennett Stanton |
First Address | Mount Clemens, MI 48043-2105 |
Second Address | Mount Clemens, MI 48043-2105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2006 |
Last Update Date | 08/07/2007 |