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Individual

DR. ANDREW JOHN STASKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Mailing address
332 2ND AVE N, WAHPETON, ND 58075-4528
(701) 642-7000
(701) 642-7055

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10708
ND
208600000X
Surgery Physician
D0057295
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1052517
PREFERREDONE
05
14398
ND
05
248487100
MN
01
30107
ND BCBS
NC
05
511208700
MD
01
HP84016
HEALTHPARTNERS
01
PENDING
MN BCBS
Enumeration date
10/24/2006
Last updated
12/05/2024
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