Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2178 | MN |
NPI | 1336178003 |
---|---|
Provider Name | Dr. Loren Raymond Stoner |
First Address | Grand Marais, MN 55604-0125 |
Second Address | Grand Marais, MN 55604-2333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 11/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2437670 | AMERICA'S PPO (01) | MN |
422L9NO | BCBS CLINIC (01) | MN |
799327800 | (05) | MN |
T39907 | (02) | MN |