Provider Demographics
NPI:1669514428
Name:STOPAK, SAMUEL SHELDON (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:SHELDON
Last Name:STOPAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2440 M ST NW
Mailing Address - Street 2:SUITE 516
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1404
Mailing Address - Country:US
Mailing Address - Phone:202-659-0066
Mailing Address - Fax:202-466-2933
Practice Address - Street 1:2440 M ST NW
Practice Address - Street 2:SUITE 516
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1404
Practice Address - Country:US
Practice Address - Phone:202-659-0066
Practice Address - Fax:202-466-2933
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD17900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCE38365Medicare UPIN
DC574612ZF4Medicare PIN