Provider Demographics
NPI:1518281385
Name:STOEHR, MARK ADAM (LAC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ADAM
Last Name:STOEHR
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13138 MUSKRATTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21813-1160
Mailing Address - Country:US
Mailing Address - Phone:410-707-1540
Mailing Address - Fax:
Practice Address - Street 1:14203 COASTAL HWY STE 1
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-7414
Practice Address - Country:US
Practice Address - Phone:410-707-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2011-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01792171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist