NPI 1003093667

Jason Charles Stanford, PAC

Practitioner Surgical Physician Assistant Germantown, MD

Practice location

Address: 19466 Caravan Dr, Germantown, MD 20874-6220
Phone: (214) 227-2457
Fax: (214) 764-0880
Mailing address: 8110 Maple Lawn Blvd STE 235, Fulton, MD 20759-2694

Registered specialties

Surgical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence C0002208 (MD)

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Registry record

NPI: 1003093667
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jan 2008
Record last updated: 1 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.