Individual
DR. JONI MARIE STASIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
635 LOCUST STREET, MALVERN, OH 44644
(330) 863-9061
(330) 863-6492
Mailing address
635 LOCUST ST, MALVERN, OH 44644-9210
(330) 863-9061
(330) 863-6492
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35067081
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210940
ANTHEM BC BS
OH
05
—
0187837
—
OH
01
—
1389825
UNITED HEALTHCARE
OH
01
—
P00148632
RAILROAD MEDICARE
OH
Enumeration date
01/10/2006
Last updated
10/29/2013
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