Individual
BRETT S STARK
Active
Individual
BRETT S STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
225
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051503568
BLUE CROSS BLUE SHIELD
AL
01
—
051529739
BLUE CROSS BLUE SHIELD
—
01
—
051530652
BLUE CROSS BLUE SHIELD
—
01
—
480033606
RR MCR
—
Enumeration date
08/14/2006
Last updated
10/26/2020
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