Provider Demographics
NPI:1871160036
Name:STANEK, DAVID NATHAN II (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:NATHAN
Last Name:STANEK
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S 50TH ST UNIT 1100
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-6993
Mailing Address - Country:US
Mailing Address - Phone:515-270-1000
Mailing Address - Fax:
Practice Address - Street 1:640 S 50TH ST UNIT 1100
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-6993
Practice Address - Country:US
Practice Address - Phone:515-270-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-06754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine