Individual
DR. LARRY STALSONBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19829 N 27TH AVE, PHOENIX, AZ 85027-4001
(623) 879-5445
Mailing address
16346 E CRYSTAL POINT DR, FOUNTAIN HILLS, AZ 85268-8419
(480) 816-6153
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3112
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
809444
—
AZ
Enumeration date
07/16/2006
Last updated
07/08/2007
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