Provider Demographics
NPI:1619751393
Name:TUNSTALL, ARIEL SHARDAE
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:SHARDAE
Last Name:TUNSTALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 BERRY PL
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1832
Mailing Address - Country:US
Mailing Address - Phone:240-752-2646
Mailing Address - Fax:
Practice Address - Street 1:7800 BERRY PL
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-1832
Practice Address - Country:US
Practice Address - Phone:240-752-2646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR226247176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife