Healthcare Provider Details

I. General information

NPI: 1275671570
Provider Name (Legal Business Name): DONALD TIMOTHY STARZINSKI M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15858 BIRCHWOOD LN
BRAINERD MN
56401-6174
US

IV. Provider business mailing address

15858 BIRCHWOOD LN
BRAINERD MN
56401-6174
US

V. Phone/Fax

Practice location:
  • Phone: 218-828-3995
  • Fax: 218-828-8184
Mailing address:
  • Phone: 218-828-3995
  • Fax: 218-828-8184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number030305
License Number StateMN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: