Provider Demographics
NPI:1679508931
Name:STAMAS, PETER PAUL (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:PAUL
Last Name:STAMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 BELLONA AVENUE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2085
Mailing Address - Country:US
Mailing Address - Phone:410-828-1414
Mailing Address - Fax:410-828-4514
Practice Address - Street 1:8320 BELLONA AVENUE
Practice Address - Street 2:SUITE 120
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2085
Practice Address - Country:US
Practice Address - Phone:410-828-1414
Practice Address - Fax:410-828-4514
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD050NMedicare ID - Type Unspecified
C49331Medicare UPIN