Individual
DR. MICHAEL J STAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1405 MONTGOMERY DR, SANTA ROSA, CA 95405-4557
(707) 546-1922
(707) 546-1987
Mailing address
1405 MONTGOMERY DR, SANTA ROSA, CA 95405-4557
(707) 546-1922
(707) 546-1987
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E85482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G611670
CIGNA DME
CA
05
—
00G611670
—
CA
01
—
G61167
LICENSE
CA
Enumeration date
06/13/2006
Last updated
11/25/2008
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