Healthcare Provider Details

I. General information

NPI: 1578290987
Provider Name (Legal Business Name): STEPHANIE GAYLE SOLOMON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 ENGLAR RD
WESTMINSTER MD
21157-2929
US

IV. Provider business mailing address

250 ENGLAR RD
WESTMINSTER MD
21157-2929
US

V. Phone/Fax

Practice location:
  • Phone: 410-876-1761
  • Fax: 410-876-0841
Mailing address:
  • Phone: 410-876-1761
  • Fax: 410-876-0841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA2942
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: