Provider Demographics
NPI:1043409188
Name:PETER P STAMAS MD PA
Entity Type:Organization
Organization Name:PETER P STAMAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:STAMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-828-1414
Mailing Address - Street 1:8320 BELLONA AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2022
Mailing Address - Country:US
Mailing Address - Phone:410-828-1414
Mailing Address - Fax:410-828-4514
Practice Address - Street 1:8320 BELLONA AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2022
Practice Address - Country:US
Practice Address - Phone:410-828-1414
Practice Address - Fax:410-828-4514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC49331Medicare UPIN
MD050NMedicare PIN