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General NPI Number Information
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NPI Number | 1184616419
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Entity Type | Individual
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Provider Name | CHARLES DONALD STEGMAN JR. MD
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Gender | Male
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 30434 MOUNT VERNON RD
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City | PRINCESS ANNE
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State | MD
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Zip | 21853-1400
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Country | US
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Telephone | 410-651-0350
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Fax | 410-651-4857
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Provider Business Mailing Address
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Address Line | 30434 MOUNT VERNON RD
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City | PRINCESS ANNE
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State | MD
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Zip | 21853-1400
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Country | US
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Telephone | 410-651-0350
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Fax | 410-651-4857
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0025219
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | D0025219
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License Number State | MD
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