Individual
STACI M KARBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-6089
(920) 430-4585
Mailing address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-6089
(920) 430-4585
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
41332
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41332
LICENSE
WV
Enumeration date
12/05/2005
Last updated
07/18/2011
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