Provider Demographics
NPI:1740216738
Name:STARSIAK, MICHAEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:STARSIAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:NAVAL MEDICAL CENTER SAN DIEGO
Mailing Address - Street 2:34800 BOB WILSON DR
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-532-8775
Mailing Address - Fax:
Practice Address - Street 1:NAVAL MEDICAL CENTER SAN DIEGO
Practice Address - Street 2:34800 BOB WILSON DR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2014-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 99439207U00000X, 207UN0903X, 207UN0901X, 207UN0902X
GA057682207U00000X, 207UN0903X, 207UN0901X, 207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No207UN0903XAllopathic & Osteopathic PhysiciansNuclear MedicineIn Vivo & In Vitro Nuclear Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD0000Medicare UPIN
FLAI300ZMedicare PIN