MEDICARE: MS. BARBARA STEVENSON CRNA

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	207L00000X	Anesthesiology Physician	R059802	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00065152	OTHER	MD	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275516312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA STEVENSON CRNA

Provider Business Mailing Address
First Line	:	515 FAIRMOUNT AVE STE 100A
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-8520
Country	:	US
Telephone Number	:	410-494-1355
Fax Number	:	410-494-1361

Provider Business Practice Location Address
First Line	:	515 FAIRMOUNT AVE
Second Line	:	STE 100A
City	:	TOWSON
State	:	MD
Zip	:	21286-5466
Country	:	US
Telephone Number	:	410-494-1315
Fax Number	:	410-584-2244

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	12/07/2020

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Directions to “ MS. BARBARA STEVENSON CRNA” Practice Location

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