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Individual

DR. DAVID BERNARD STAAB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
576 FORT LOUDOUN MEDICAL CENTER DR, #101, LENOIR CITY, TN 37772-5676
(865) 690-5263
Mailing address
DEPT 888067, KNOXVILLE, TN 37995-8067
(865) 588-8838

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD35862
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3870535
TN
Enumeration date
08/24/2006
Last updated
07/08/2007
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