Provider Demographics
NPI:1699325712
Name:FIELDS, STANLEY LAMONTE JR
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:LAMONTE
Last Name:FIELDS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 T ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4720
Mailing Address - Country:US
Mailing Address - Phone:202-591-8190
Mailing Address - Fax:
Practice Address - Street 1:1700 T ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4720
Practice Address - Country:US
Practice Address - Phone:202-591-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1329721172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver