Individual
DOUGLAS JOHN STAVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ABO
Contact information
Practice address
1547 SO UNIVERSITY DR, FARGO, ND 58103
(701) 235-5185
(701) 232-4965
Mailing address
1547 SO UNIVERSITY DR, FARGO, ND 58103
(701) 235-5185
(701) 232-4965
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
11/16/2006
Last updated
02/04/2009
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