Provider Demographics
NPI:1326082645
Name:STANZIALE, STEPHEN F (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:STANZIALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:SUITE 2700N
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-723-5524
Mailing Address - Fax:202-291-0512
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:SUITE 520
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3046
Practice Address - Country:US
Practice Address - Phone:410-573-6480
Practice Address - Fax:410-573-7981
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CD0361OtherRAILROAD MEDICARE GROUP N
MD411533300Medicaid
MD066MOtherGROUP MEDICARE NO.
MD066MP045OtherINDIV MEDICARE
DC409629OtherMEDICARE GROUP
DC409629OtherMEDICARE GROUP
MDI66598Medicare UPIN