Norman Russell Stackhouse P.A.

NPI 1053412569 - Physician Assistant - 363AM0700X

NPI Details
NPI 1053412569
Gender Male
Enumeration Date 09/26/2006
Last Updated 07/09/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
9131 PISCATAWAY RD
SUITE 600
CLINTON MD, 20735-2508, US
Phone (301) 868-0110
Fax (301) 856-0604
Business Location
9131 PISCATAWAY RD
SUITE 600
CLINTON MD, 20735-2508, US
Phone (301) 868-0110
Fax (301) 856-0604
Toxanomy
Taxonomy Code 363AM0700X
License State Maryland
License Number C0000861
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According to our database, Norman Russell Stackhouse P.A. NPI is 1053412569, taxonomy code is 363AM0700X and license number is C0000861, license state is located at Maryland. Norman Russell Stackhouse P.A. physically located at 9131 Piscataway Rd, Clinton MD, 20735-2508. NPI Number Norman Russell Stackhouse P.A. has the Individual type.

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1053412569 NPI number is provided on an as is basis without warranty of any kind. 1053412569 is maintained by the National Plan & Provider Enumeration System. The contents of Norman Russell Stackhouse P.A. are for informational purposes only.