Individual
MARIA K STATTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5180
(218) 759-5438
Mailing address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5180
(218) 759-5438
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36844
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
960315800
—
MN
Enumeration date
07/22/2006
Last updated
05/07/2012
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