1578656625 NPI number — SUSAN F STINSON M.D.

Table of content: SUSAN F STINSON M.D. (NPI 1578656625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578656625 NPI number — SUSAN F STINSON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STINSON
Provider First Name:
SUSAN
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578656625
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6201 GREENLEIGH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIDDLE RIVER
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21220-2004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6420 ROCKLEDGE DR
Provider Second Line Business Practice Location Address:
SUITE 1200
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20817-7837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-896-6331
Provider Business Practice Location Address Fax Number:
301-897-1331
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  D0034840 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 074981800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 210003390796 . This is a "BEECH STREET" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1129653 . This is a "FIRST HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 501464 . This is a "NATIONAL CAPITAL PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0749818-00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0051037010 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3600606 . This is a "UNITED HEALTHCARE MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 613717-01 . This is a "CAREFIRST BC/BS MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1250206 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 97332 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0109741-00 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2138230 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: S357-0001 . This is a "CAREFIRST BC/BS DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 2640296 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5496528 . This is a "AETNA PPO/POS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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