SearchWisconsin164X00000X

Michael Stark

NPI 1194617647 · on the registry since 2025

Practice

Address
12049 44th Ave
Pleasant Prairie, WI 53158
Phone
(530) 562-5476

Registry record

Primary taxonomy
164X00000X
164X00000X
Also registered as
164X00000X
Licence states on file
CA, IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-07-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin