Basic Information
| Provider Information | |||||||||
| NPI: | 1912937970 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAIST | ||||||||
| FirstName: | STANLEY | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 COLUMBIA AVE | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176034154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173972738 | ||||||||
| FaxNumber: | 7173977634 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 COLUMBIA AVE | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176034154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173972738 | ||||||||
| FaxNumber: | 7173977634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 10/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD020972E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000001120 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 0012929390012 | 05 | PA | MEDICAID | 0038383000 | 01 | PA | INDEPENDENCE BLUE CROSS | OTHER | 100338I | 01 | PA | AMERIHEALTH MERCY | OTHER | 080179262 | 01 | PA | RAILROAD MEDICARE | OTHER | 35648 | 01 | PA | GEISINGER | OTHER | 000000127144 | 01 | PA | UNISON | OTHER | 4059461 | 01 | PA | AETNA | OTHER | 50082752 | 01 | PA | CAPITAL BLUE CROSS | OTHER | P009623 | 01 | PA | GATEWAY | OTHER |