Individual
MICHAEL PATRICK STAEBLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
345 VALLEY RD, MIDDLETOWN, RI 02842-5236
(401) 842-0555
(401) 847-5450
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
(401) 842-0555
(401) 847-5450
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD09775
RI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD09775
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201596530
TRICARE
RI
05
—
7006584
—
RI
Enumeration date
01/03/2007
Last updated
06/08/2015
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