Individual
ROBERT MICHAEL STACK
Active
Individual
ROBERT MICHAEL STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
78268
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0761430001
DMERC
NM
01
—
16010
HMO
NM
01
—
26210
PRESBYTERIAN
NM
01
—
2666
BC BS
NM
01
—
39445593
CHAMPUS
NM
01
—
88005C005
TRICARE
NM
Enumeration date
08/23/2005
Last updated
10/29/2007
Update your record
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