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Individual

MICHAEL L. STAKER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
28 OFFICER CIR, TOOELE, UT 84074-6061
(435) 833-2572
Mailing address
4500 S 4000 W, WEST VALLEY CITY, UT 84120-6235
(435) 833-2572

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
5248029-1205
UT

Other

Enumeration date
03/31/2006
Last updated
07/08/2007
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