Individual
ROBERT A STAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1715 E 12TH ST, THE DALLES, OR 97058-3136
(541) 296-2294
Mailing address
1715 E 12TH ST, THE DALLES, OR 97058-3136
(541) 296-2294
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD09164
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181271
—
OR
05
—
8299703
—
WA
Enumeration date
10/11/2005
Last updated
10/08/2007
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