Individual
SHELLY M STASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 WILLMAR AVE SW, WILLMAR, MN 56201
(320) 231-5000
(320) 231-5026
Mailing address
101 WILLMAR AVE SW, WILLMAR, MN 56201
(320) 231-5079
(320) 231-5067
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46869
MN
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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