Individual
CHAD ALLEN STADSVOLD
Active
Individual
CHAD ALLEN STADSVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R8139
IA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4175
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00606
—
IA
Enumeration date
06/19/2007
Last updated
07/27/2015
Update your record
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