Healthcare Provider Details

I. General information

NPI: 1245577675
Provider Name (Legal Business Name): JOHN ADAM STAPLES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2013
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 BURRARD ST ROOM 5910B
VANCOUVER BC
V6Z1Y6
CA

IV. Provider business mailing address

1002 - 1025 GILFORD ST
VANCOUVER BC
V6G2P2
CA

V. Phone/Fax

Practice location:
  • Phone: 604-682-2344
  • Fax:
Mailing address:
  • Phone: 604-868-6875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD60305892
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: