DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. LISA DEETTE STABER, MD

Active Sole Proprietor

DR. LISA DEETTE STABER, MD is a Family Medicine healthcare provider located in GRAND RAPIDS, Minnesota. NPI 1629035308 is currently active in the NPPES registry. Verify at CMS.

Family Medicine · GRAND RAPIDS, MN

Registration Details

NPI Number
1629035308
Provider Type
Individual
Gender
Female
NPI Issued
Apr 27, 2006 (20.300506253669 yrs)
Last Updated
May 9, 2017
Licenses
4301086765 (MI)
38751-020 (WI)
38922 (MN)
38751-20 (WI)
Sole Proprietor
Yes

Practice Information

Address
20635 MISHAWAKA SHORES TRL
GRAND RAPIDS, MN, 557446071
Browse MN providers · Browse ZIP 55744
Phone
2183980256
Primary Specialty
Family Medicine
207Q00000X
Additional Specialty
Family Medicine
Additional Specialty
Family Medicine
Additional Specialty
Family Medicine

Other Family Medicine Providers in GRAND RAPIDS, MN

Name Credential NPI
DR. JACK VICTOR CARLISLE MD 1326023060
DR. PATRICIA C. CARLIN-JANSSEN MD 1033195805
DR. CATHY J. CLEARY MD 1811973670
DR. EDWIN A. ANDERSON MD 1083691828
DR. CARY R. COLE-ANTHONY MD 1437136090
DR. SCOTT GERLING MD 1912984550
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.