Basic Information
| Provider Information | |||||||||
| NPI: | 1265694335 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STALIN | ||||||||
| FirstName: | VASANTH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1015 S WASHINGTON AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486012556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9899078716 | ||||||||
| FaxNumber: | 9899078207 | ||||||||
| Practice Location | |||||||||
| Address1: | 912 S WASHINGTON AVE | ||||||||
| Address2: | STE. 1 | ||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486012564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897901001 | ||||||||
| FaxNumber: | 9897901002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2008 | ||||||||
| LastUpdateDate: | 07/24/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD28996 | OR | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 91503 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 4301097830 | MI | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.