Healthcare Provider Details

I. General information

NPI: 1336209840
Provider Name (Legal Business Name): STEPHEN C. LOBAUGH O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 WILSON LN FL 3
BETHESDA MD
20814-2455
US

IV. Provider business mailing address

5001 WILSON LN FL 3
BETHESDA MD
20814-2455
US

V. Phone/Fax

Practice location:
  • Phone: 301-951-2020
  • Fax: 202-393-1527
Mailing address:
  • Phone: 301-841-6776
  • Fax: 202-393-1527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA1473
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOP1000011
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: