MEDICARE: CRAIG STACHEWICZ P.A.

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	363A00000X	Physician Assistant	C0007916	MD

General Provider Information

NPI Number	:	1891007951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG STACHEWICZ P.A.

Provider Business Mailing Address
First Line	:	1 FREDERICK HEALTH WAY
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701-9435
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 E FREDERICK ST
Second Line	:
City	:	WALKERSVILLE
State	:	MD
Zip	:	21793-8234
Country	:	US
Telephone Number	:	240-215-6310
Fax Number	:	240-566-7754

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

Provider Enumeration Date	:	07/06/2010
Last Update Date	:	07/07/2025

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