Individual
ROBERT DENNIS STATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 32ND AVE S, MOORHEAD, MN 56560-5001
(218) 233-7524
(218) 233-8627
Mailing address
3001 BOHNET BLVD N, FARGO, ND 58102-1726
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25212
MN
2084P0800X
Psychiatry Physician
4169
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099398100
—
MN
01
—
1010543
PREFERREDONE
MN
01
—
116458
UCARE MINNESOTA
MN
05
—
1455906
—
ND
01
—
59200ST
BLUE SHIELD OF MINNESOTA
MN
Enumeration date
06/02/2006
Last updated
04/11/2017
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