Individual
DR. DEREC STANISLAV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
201 NW RD MIZE ROAD, BLUE SPRINGS, MO 64014
(816) 655-5426
(816) 655-5408
Mailing address
201 NW RD MIZE ROAD, BLUE SPRINGS, MO 64014
(816) 655-5426
(816) 655-5408
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2018021972
MO
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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