Provider Demographics
NPI:1619107935
Name:STEGMAN, ROBERT KILLIAN JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:KILLIAN
Last Name:STEGMAN
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 S MARLYN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-5038
Mailing Address - Country:US
Mailing Address - Phone:410-735-5378
Mailing Address - Fax:410-735-5379
Practice Address - Street 1:1515 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-1735
Practice Address - Country:US
Practice Address - Phone:410-735-5378
Practice Address - Fax:410-735-5379
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist