Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | D0052549 | MD |
NPI | 1003927757 |
---|---|
Provider Name | Stacy B Stryer |
First Address | Rockville, MD 20850-3215 |
Second Address | Rockville, MD 20850-3215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |