Individual
JOHN DAVID STAGEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 557-5460
(719) 560-7217
Mailing address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 557-5460
(719) 560-7217
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
41213
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55351760
—
CO
Enumeration date
04/17/2006
Last updated
07/20/2013
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