Provider Demographics
NPI:1386628055
Name:GEORGE, STEPHEN WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WAYNE
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12324 FOX MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:WEST FRIENDSHIP
Mailing Address - State:MD
Mailing Address - Zip Code:21794-9515
Mailing Address - Country:US
Mailing Address - Phone:410-489-2517
Mailing Address - Fax:410-992-4441
Practice Address - Street 1:6350 STEVENS FOREST RD STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3240
Practice Address - Country:US
Practice Address - Phone:410-992-7440
Practice Address - Fax:410-762-0349
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2023-09-08
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Provider Licenses
StateLicense IDTaxonomies
MDD43195207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD193111300Medicaid
MDK910Medicare ID - Type Unspecified
MD193111300Medicaid