Graduated: 1989
NPI: 1942395546
Practice Locations (2)
STATERA HEALTH CARE LLC
200 E FAIRMAN AVE
WATSEKA, IL 609701644
8154325841
PAULDING COUNTY HOSPITAL PHYSICIAN SERVICES
1032 W WAYNE ST
PAULDING, OH 458791545
4193991104
Source: CMS National Downloadable File, September 2026.