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Contact Information

VITALIY STAROSTA, M.D., PH.D.
801 BROADWAY N
FARGO, ND58102
 Phone: 701-234-2525
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
 

General Acute Care Hospital

282N00000X A0[7] Hospital-General
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for VITALIY STAROSTA · (Male)

NPI Number 1336443233
Status Active
Credentials M.D., PH.D.
Entity Individual
Enumeration date 01/06/2011
Last updated 08/01/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • ND License # 12702
  • MN Medicaid 1336443233
  • ND Medicaid 18151
Hospital affiliation(s)
  • SANFORD MEDICAL CENTER FARGO - (Acute Care)
    801 BROADWAY NORTH
    FARGO, ND 58122
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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