Organization
CHARLES ROYDEN STAUBS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES STAUBS D.O. (PHYSICIAN OWNER)
(715) 409-0121
Entity
Organization
Contact information
Practice address
850 NAUGART DR, MERRILL, WI 54452-9148
(715) 409-0121
Mailing address
850 NAUGART DR, MERRILL, WI 54452-9148
(715) 409-0121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
H42911
MD
261QP2300X
Primary Care Clinic/Center
Primary
50267-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045951800
—
MD
01
—
T843
CAREFIRST BC BS
MD
Enumeration date
01/28/2006
Last updated
05/09/2013
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