Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | D86415 | MD |
N | 2080P0203X | Pediatric Critical Care Doctor | MD32502 | DC |
NPI | 1275610560 |
---|---|
Provider Name | David Stockwell |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 05/01/2019 |