Stulc, Diana Minasian

Stulc, Diana Minasian is an individual health care provider with primary practice located at 969 Lakeland Dr , Jackson MS 39216-4606. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Stulc, Diana Minasian can be contacted via phone (615) 377-5658.

Contact Information

Primary practice address
969 Lakeland Dr Jackson MS 39216-4606
Phone: (615) 377-5658
Fax: (888) 241-1404
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20783 Mississippi
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36090 Kentucky

Profile Details

NPI number 1225002165
LBN Legal business name Stulc, Diana Minasian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2006
Last updated Dec 21st, 2009 - about 16 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 1225002165 NPPES
Mississippi MEDICAID 01139543
Mississippi MEDICAID 64024268

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