Provider Demographics
NPI:1437360815
Name:STASIK, CHRISTOPHER JOHN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:STASIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 N 3RD STREET
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2432
Mailing Address - Country:US
Mailing Address - Phone:602-633-3800
Mailing Address - Fax:602-861-3500
Practice Address - Street 1:9250 N 3RD STREET
Practice Address - Street 2:SUITE 4000
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2432
Practice Address - Country:US
Practice Address - Phone:602-633-3800
Practice Address - Fax:602-861-3500
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6057207ZP0102X
AZ4696207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ430268Medicaid
AZ430268Medicaid