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Individual
JUDITH M STARK
Active
Individual
JUDITH M STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28363
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00465ST
BCBS
MN
01
—
0710811
MEDICA
MN
05
—
237780200
—
MN
Enumeration date
08/19/2006
Last updated
09/15/2011
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