MEDICARE: DR. ROBERT SCOTT STUTMAN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TA1383	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LS06	OTHER	MD	BCBS MD PROVIDER #
2	E6890000	OTHER	DC	BCBS DC PROVIDER #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205913027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT SCOTT STUTMAN O.D.

Provider Business Mailing Address
First Line	:	8601 LASALLE RD
Second Line	:	SUITE 108
City	:	TOWSON
State	:	MD
Zip	:	21286-2004
Country	:	US
Telephone Number	:	410-821-6400
Fax Number	:	410-296-4722

Provider Business Practice Location Address
First Line	:	8601 LASALLE RD
Second Line	:	SUITE 108
City	:	TOWSON
State	:	MD
Zip	:	21286-2004
Country	:	US
Telephone Number	:	410-821-6400
Fax Number	:	410-296-4722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	04/03/2013

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