MEDICARE: DR. SAM M STUMER OD

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	DA1451	MD
2	152W00000X	Optometrist	0618000301	VA
3	152W00000X	Optometrist	I3-0011439	DE

General Provider Information

NPI Number	:	1881756476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAM M STUMER OD

Provider Business Mailing Address
First Line	:	18756 COASTAL HWY UNIT 2
Second Line	:
City	:	REHOBOTH BEACH
State	:	DE
Zip	:	19971-6155
Country	:	US
Telephone Number	:	302-645-4789
Fax Number	:	844-876-6925

Provider Business Practice Location Address
First Line	:	18756 COASTAL HWY UNIT 2
Second Line	:
City	:	REHOBOTH BEACH
State	:	DE
Zip	:	19971-6155
Country	:	US
Telephone Number	:	302-645-4789
Fax Number	:	844-876-6925

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	01/31/2023

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