Doctor Name: | TERRY L STAKE |
NPI Number: | 1023085552 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 14313 |
Business Practice Address: | 1 Medical Park Wheeling, WV - 260036379 |
Business Phone Number: | 3042433270 |
Business Fax Number: | |
Mailing Address: | Po Box 5307, LIMA |
State: | OH |
Postal Code: | 458025307 |
Phone Number: | 4192245707 |
Fax Number: | 4192290040 |
NPI Enumeration Date: | 03/03/2006 |
NPI Last Update Date: | 07/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 14313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |