Individual
MATHEW LLOYD STAYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
929 CENTRAL AVE NW, EAST GRAND FORKS, MN 56721-1917
(218) 773-6800
Mailing address
929 CENTRAL AVE NW, EAST GRAND FORKS, MN 56721-1917
(218) 773-6800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44098
MN
207Q00000X
Family Medicine Physician
8225
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123580
MEDICA
—
05
—
10952
—
ND
01
—
26485
BCBS
ND
01
—
500M3ST
BCBS
MN
05
—
991483800
—
MN
01
—
HP34258
HEALTHPARTNERS
—
01
—
NA4571028643
PREFERRED ONE
—
Enumeration date
05/28/2006
Last updated
10/27/2022
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