Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101234499 | VA |
N | 208000000X | Pediatrician | 0101234499 | VA |
NPI | 1225007644 |
---|---|
Provider Name | Dr. Shayne C Stokes |
First Address | Joint Base Andrews, MD 20637 |
Second Address | Albuquerque, NM 87117-5522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 16/04/2018 |