Staser, Jonathan Andrew
Staser, Jonathan Andrew is an individual health care provider with primary practice located at 429 S Landmark Avenue , Bloomington IN 47403-5003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Staser, Jonathan Andrew can be contacted via phone (812) 332-8242.Contact Information
Primary practice address
429 S Landmark Avenue
Bloomington IN 47403-5003
Phone: (812) 332-8242
Fax: (812) 333-7684
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01060288A | Indiana |
Profile Details
| NPI number | 1043339310 |
|---|---|
| LBN Legal business name | Staser, Jonathan Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Jul 26th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043339310 | NPPES |
| Iowa | Other | 50249 | WELLMARK BCBS |
| Iowa | MEDICAID | 200864320 | WELLMARK BCBS |
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