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Individual

DANIEL MATTHEW STASIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
801 E WILLIAMS AVE, FALLON, NV 89406-3052
(775) 867-7740
(775) 423-4219
Mailing address
801 E WILLIAMS AVE, FALLON, NV 89406-3052
(775) 867-7740

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1133
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12196146
CAQH
Enumeration date
09/24/2008
Last updated
03/08/2022
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