Staron, Jeffrey S

Staron, Jeffrey S is an individual health care provider with primary practice located at 8141 Calumet Ave Unit 1 , Munster IN 46321-1701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Staron, Jeffrey S can be contacted via phone (219) 961-9480.

Contact Information

Primary practice address
8141 Calumet Ave Unit 1 Munster IN 46321-1701
Phone: (219) 961-9480
Fax: (630) 718-6057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 036139164 Illinois
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 01066936A Indiana

Profile Details

NPI number 1780723122
LBN Legal business name Staron, Jeffrey S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jan 4th, 2019 - about 7 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 1780723122 NPPES
Indiana Other 1669472270 NPI GROUP NUMBER

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