Provider Information for 1780407163
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Mr. TOMARIO C STAMPS I MSW
Sex: Male
NPI: 1780407163
Last Updated: 2025-01-29
Certification Date: 2025-01-29
Certification Date: 2025-01-29
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1780407163 | ||||||||
| Enumeration Date | 2024-11-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 200 COLUMBUS DR BELLEVILLE, IL 62226-6042 United States Phone: 601-899-2117 | Fax: | ||||||||
| Primary Practice Address | 200 COLUMBUS DR BELLEVILLE, IL 62226-6042 United States Phone: 601-899-2117 | Fax: | ||||||||
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