Martavia Stanford, LABORATORY DIRECTOR in Brookfield, WI - Technician, Pathology

Martavia Stanford, LABORATORY DIRECTOR is a Technician, Pathology - Clinical Laboratory Director, Non-physician based in Brookfield, Wisconsin. Martavia Stanford is licensed to practice in Wisconsin (license number 52D2261520) and her current practice location is 120 Bishops Way Ste 165, Brookfield, Wisconsin. She can be reached at her office (for appointments etc.) via phone at (414) 355-5525.

NPI number for Martavia Stanford is 1548985930 and her current mailing address is 120 Bishops Way Ste 165, Brookfield, Wisconsin. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1548985930.

Contact Information

	Martavia Stanford, LABORATORY DIRECTOR
	120 Bishops Way Ste 165, Brookfield, WI 53005-6249
	(414) 355-5525
	(414) 240-4595

Healthcare Provider's Profile

Full Name	Martavia Stanford
Gender	Female
Speciality	Technician, Pathology - Clinical Laboratory Director, Non-physician
Location	120 Bishops Way Ste 165, Brookfield, Wisconsin
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1548985930
Provider Enumeration Date: 10/07/2022
Last Update Date: 10/07/2022

Medical Identifiers

Medical identifiers for Martavia Stanford such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548985930	NPI	-	NPPES
52D2261520	Other	WI	CLIA STATE OF WISCONSIN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP1600X	Counselor - Pastoral	(* (Not Available))	Secondary
372600000X	Adult Companion	(* (Not Available))	Secondary
374U00000X	Home Health Aide	(* (Not Available))	Secondary
376J00000X	Homemaker	(* (Not Available))	Secondary
247ZC0005X	Technician, Pathology - Clinical Laboratory Director, Non-physician	52D2261520 (Wisconsin)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Martavia Stanford is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Martavia Stanford, LABORATORY DIRECTOR 120 Bishops Way Ste 165, Brookfield, WI 53005-6249 Ph: (414) 355-5525	Martavia Stanford, LABORATORY DIRECTOR 120 Bishops Way Ste 165, Brookfield, WI 53005-6249 Ph: (414) 355-5525

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Martavia Stanford, LABORATORY DIRECTOR - Counselor in Brookfield, WI