Provider Demographics
NPI:1962678649
Name:BLOSSER, STELLA LII (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:LII
Last Name:BLOSSER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:STELLA
Other - Middle Name:JOYCE
Other - Last Name:LII
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,MPH
Mailing Address - Street 1:PO BOX 37230
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:129 LUBRANO DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7564
Practice Address - Country:US
Practice Address - Phone:410-897-0501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116018314207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology