Basic Information
| Provider Information | |||||||||
| NPI: | 1922196773 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STASZEL | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | W. | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 46572 ROCKFORD DR | ||||||||
| Address2: | |||||||||
| City: | SHELBY TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483155630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546991025 | ||||||||
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| Practice Location | |||||||||
| Address1: | 33089 GROESBECK HWY | ||||||||
| Address2: | |||||||||
| City: | FRASER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480261501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862962800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 12/14/2017 | ||||||||
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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 | 2085R0202X | ME70950 | FL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.