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NPI Code Detail

MEDICARE: BRYAN D STAFFIN DO

MEDICARE: BRYAN D STAFFIN DO
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
1207P00000XEmergency Medicine Physician02001116AIN
2207P00000XEmergency Medicine Physician993558MI

General Provider Information

NPI Number : 1689668204
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN D STAFFIN DO
Provider Business Mailing Address
First Line : 254 MOUNT TABOR RD
Second Line :
City : BUCHANAN
State : MI
Zip : 49107-8328
Country : US
Telephone Number : 269-422-2925
Fax Number :
Provider Business Practice Location Address
First Line : 1234 NAPIER AVE
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-2112
Country : US
Telephone Number : 269-985-4541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 07/08/2007

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Directions to “ BRYAN D STAFFIN DO” Practice Location

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