Stafstrom, Carl E

Stafstrom, Carl E is an individual health care provider with primary practice located at 200 N Wolfe St , Baltimore MD 21287-0011. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is his primary health care specialty. Stafstrom, Carl E can be contacted via phone (410) 955-4259.

Contact Information

Primary practice address
200 N Wolfe St Baltimore MD 21287-0011
Phone: (410) 955-4259
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 41489 Wisconsin
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 41489 Wisconsin
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X D77086 Maryland

Profile Details

NPI number 1912979196
LBN Legal business name Stafstrom, Carl E
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Nov 7th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912979196 NPPES
Maryland MEDICAID 073165000

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