Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | D0025219 | MD |
N | 207QG0300X | Family Doctor - Geriatric Medicine | D0025219 | MD |
NPI | 1184616419 |
---|---|
Provider Name | Mr. Charles Donald Stegman JR. |
First Address | Princess Anne, MD 21853-1400 |
Second Address | Princess Anne, MD 21853-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 18/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010000842 | RAILROAD MEDICARE (01) | MD |
367003 | MAMSI (01) | MD |
53032103 | BLUE SHIELD (01) | MD |
74480 | COVENTRY OF DELEWARE (01) | |
786991600 | (05) | MD |
D64784 | (02) | |
H8236 | FIRST HEALTH (01) | |
T8890001 | BLUE SHIELD CHOICE (01) | MD |