Individual
MICHAEL LEE STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1118 FAIRINGTON DR, SIDNEY, OH 45365-8913
(937) 492-3755
(937) 492-1132
Mailing address
4445 LAKE FOREST DR STE 600, BLUE ASH, OH 45242-3744
(513) 569-3741
(937) 492-1132
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
3380
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0533462
—
OH
Enumeration date
06/24/2005
Last updated
09/16/2020
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