Individual
DR. DOUGLAS R STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2109 N MAIN ST, COEUR D ALENE, ID 83814
(208) 676-0104
(208) 765-1893
Mailing address
2109 N MAIN ST, COEUR D ALENE, ID 83814
(208) 676-0104
(208) 765-1893
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
M7604
ID
Other
Enumeration date
08/12/2005
Last updated
01/18/2017
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