Individual
DR. ZACHERY TYLER STASKYWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
UNIVERSITY OF NORTH DAKOTA SMHS DEPARTMENT OF SURGERY, 1301 NORTH COLUMBIA ROAD STOP 9037, GRAND FORKS, ND 58202
(701) 293-4151
(701) 293-4148
Mailing address
UNIVERSITY OF NORTH DAKOTA SMHS DEPARTMENT OF SURGERY, 1301 NORTH COLUMBIA ROAD STOP 9037, GRAND FORKS, ND 58202
(701) 293-4151
(701) 293-4148
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
RL15810
ND
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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