Healthcare Provider Details
I. General information
NPI: 1831270719
Provider Name (Legal Business Name): DONALD J STINAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/18/2006
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 E 11TH ST
SILVER CITY NM
88061-5510
US
IV. Provider business mailing address
PO BOX 2857
SILVER CITY NM
88062-2857
US
V. Phone/Fax
- Phone: 505-388-0184
- Fax: 505-388-0186
- Phone: 575-388-0184
- Fax: 505-388-0186
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 97381 |
| License Number State | NM |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 97381 |
| License Number State | NM |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 97381 |
| License Number State | NM |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 97381 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: