NPI 1043329220

Jerry Wayne Stanke, MD

Practitioner Dermatology Physician Saint Paul, MN

Practice location

Address: 3555 Willow Lake Blvd Suite 240, Saint Paul, MN 55110-5131
Phone: (651) 770-0110
Fax: (651) 770-0134
Mailing address: 60 Plato Blvd E Suite 270, Saint Paul, MN 55107-1827

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 22442 (MN)

Other Dermatology providers in Minnesota →

Registry record

NPI: 1043329220
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Aug 2006
Record last updated: 28 Jan 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.