Provider Demographics
NPI:1194025569
Name:DEMARCO, STACY (L AC)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 OLD HARFORD RD STE 100A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2803
Mailing Address - Country:US
Mailing Address - Phone:443-468-6163
Mailing Address - Fax:
Practice Address - Street 1:8700 OLD HARFORD RD STE 100A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-2803
Practice Address - Country:US
Practice Address - Phone:443-468-6163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01850171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist