Provider Demographics
NPI:1972583904
Name:STANFIELD, LAURA A (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:STANFIELD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8926 WOODYARD RD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4220
Mailing Address - Country:US
Mailing Address - Phone:301-856-1682
Mailing Address - Fax:301-856-8214
Practice Address - Street 1:8926 WOODYARD RD
Practice Address - Street 2:SUITE 701
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4220
Practice Address - Country:US
Practice Address - Phone:301-856-1682
Practice Address - Fax:301-856-8214
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003860363AM0700X
AZ2598363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
142435ZAKWOtherMEDICARE METRO
145530100OtherDEPARTMENT OF LABOR
144937YZWOtherMARYLAND MEDICARE
145530100OtherDEPARTMENT OF LABOR
0254450002Medicare NSC
0254450001Medicare NSC