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General NPI Number Information
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NPI Number | 1780655928
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Entity Type | Individual
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Provider Name | RON H STARK M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3077 N MAYFAIR RD SUITE 306
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City | MILWAUKEE
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State | WI
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Zip | 53222-4305
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Country | US
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Telephone | 414-258-2323
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Fax | 414-258-2736
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Provider Business Mailing Address
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Address Line | 3077 N MAYFAIR RD SUITE 306
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City | MILWAUKEE
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State | WI
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Zip | 53222-4305
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Country | US
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Telephone | 414-258-2323
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Fax | 414-258-2736
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 22545
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License Number State | WI
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