Stark, Owen

Stark, Owen is an individual health care provider with primary practice located at 5333 Mcauley Dr Suite 6016, Ypsilanti MI 48197-1014. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Stark, Owen can be contacted via phone (734) 712-8350.

Contact Information

Primary practice address
5333 Mcauley Dr Suite 6016 Ypsilanti MI 48197-1014
Phone: (734) 712-8350
Fax: (734) 712-8251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD443256 Pennsylvania
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 57012650 Ohio
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD443256 Pennsylvania
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 4301083869 Michigan

Profile Details

NPI number 1073709531
LBN Legal business name Stark, Owen
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2007
Last updated Jul 9th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073709531 NPPES
Pennsylvania MEDICAID 102628033

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