SearchIdaho2086S0129X

Douglas Stafford, M.D

NPI 1598767196 · on the registry since 2005 · sole proprietor

Practice

Address
2109 N Main St
Coeur D Alene, ID 83814
Phone
(208) 676-0104
Fax
(208) 765-1893
Organisation at this address
Venia, Pllc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
2086S0129X
2086S0129X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2017-01-18

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 Idaho