Provider Demographics
NPI:1457304644
Name:STEDMAN, MARY L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:L
Last Name:STEDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14506 UNIVERSITY POINT PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-5425
Mailing Address - Country:US
Mailing Address - Phone:813-971-8311
Mailing Address - Fax:813-971-0862
Practice Address - Street 1:14506 UNIVERSITY POINT PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-971-8311
Practice Address - Fax:813-971-0862
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2018-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME00540312084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF30981Medicare UPIN