Individual
DR. LARRY VICTOR STAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
60 E SOUTH TEMPLE, EAGLE GATE PLAZA, 3RD FLOOR, SALT LAKE CITY, UT 84111-1004
(801) 578-5882
Mailing address
60 E SOUTH TEMPLE, EAGLE GATE PLAZA, 3RD FLOOR, SALT LAKE CITY, UT 84111-1004
(801) 578-5882
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
150350-1205
UT
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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