| Doctor Name: | VICTOR LOUIS STAVA |
| NPI Number: | 1154515245 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 1011 |
| Business Practice Address: | 1401 E H St Mc Cook, NE - 690013589 |
| Business Phone Number: | 3083444110 |
| Business Fax Number: | 3083448369 |
| Mailing Address: | 1401 E H St, P.o. Box 1207 MC COOK |
| State: | NE |
| Postal Code: | 690013589 |
| Phone Number: | 3083444110 |
| Fax Number: | 3083448369 |
| NPI Enumeration Date: | 08/31/2007 |
| NPI Last Update Date: | 07/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1011 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |