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NPI Code Detail

MEDICARE: MS. SHARON L. STAKE MD

MEDICARE: MS. SHARON L. STAKE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician32621-20WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942271846
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHARON L. STAKE MD
Provider Business Mailing Address
First Line : 3524 E MILWAUKEE ST
Second Line :
City : JANESVILLE
State : WI
Zip : 53546-1626
Country : US
Telephone Number : 608-756-7100
Fax Number : 608-756-4700
Provider Business Practice Location Address
First Line : 3524 E MILWAUKEE ST
Second Line :
City : JANESVILLE
State : WI
Zip : 53546-1626
Country : US
Telephone Number : 608-756-7100
Fax Number : 608-756-4700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 04/25/2024

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