Individual
DR. MICHAEL E. STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 REGENCY CT, STE 100, TOLEDO, OH 43623-3075
(419) 841-6600
(419) 841-6677
Mailing address
2000 REGENCY CT, STE 100, TOLEDO, OH 43623-3075
(419) 841-6600
(419) 841-6677
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
042794
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0488502
—
OH
01
—
104389683
MICHIGAN MEDICAID
MI
Enumeration date
05/24/2005
Last updated
01/05/2012
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