Individual
JONATHAN SIMON STAUB
Active
Individual
JONATHAN SIMON STAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9400646
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110123217
RAILROAD MEDICARE
NC
01
—
79424
BCBS NC
NC
05
—
8979424
—
NC
Enumeration date
09/26/2006
Last updated
08/13/2014
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