Individual
JEFFREY S STARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8141 CALUMET AVE UNIT 1, MUNSTER, IN 46321-1701
(219) 961-9480
(630) 718-6057
Mailing address
8141 CALUMET AVE UNIT 1, MUNSTER, IN 46321-1701
(219) 961-9480
(630) 718-6057
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
01066936A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036139164
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669472270
NPI GROUP NUMBER
IN
Enumeration date
02/05/2007
Last updated
01/04/2019
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