Provider Demographics
NPI:1578656625
Name:STINSON, SUSAN F (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:F
Last Name:STINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6420 ROCKLEDGE DR
Practice Address - Street 2:SUITE 1200
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7837
Practice Address - Country:US
Practice Address - Phone:301-896-6331
Practice Address - Fax:301-897-1331
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00348402085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD074981800Medicaid
MD210003390796OtherBEECH STREET
MD1129653OtherFIRST HEALTH
501464OtherNATIONAL CAPITAL PPO
MD0749818-00Medicaid
MD0051037010OtherCIGNA
MD3600606OtherUNITED HEALTHCARE MD
MD613717-01OtherCAREFIRST BC/BS MD
1250206OtherUNITED HEALTHCARE
MD97332OtherAMERIGROUP
DC0109741-00Medicaid
MD2138230OtherMAMSI
DCS357-0001OtherCAREFIRST BC/BS DC
MD2640296OtherAETNA HMO
MD5496528OtherAETNA PPO/POS
MD00A967S56Medicare PIN
MD2640296OtherAETNA HMO
MD613717-01OtherCAREFIRST BC/BS MD
1250206OtherUNITED HEALTHCARE