Provider Demographics
NPI:1134220023
Name:KRIMINS, STANLEY DAVID (MD FACP)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:DAVID
Last Name:KRIMINS
Suffix:
Gender:M
Credentials:MD FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 RIDGELY AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1441
Mailing Address - Country:US
Mailing Address - Phone:410-268-8992
Mailing Address - Fax:410-268-8909
Practice Address - Street 1:104 RIDGELY AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1441
Practice Address - Country:US
Practice Address - Phone:410-268-8992
Practice Address - Fax:410-268-8909
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD23142207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD41644402OtherBLUE SHIELD OF MD
MD975981600Medicaid
MDW3630001OtherBLUE SHIELD DC
MD110179861OtherRAILROAD MEDICARE
MDW3630001OtherBLUE SHIELD DC
B70523Medicare UPIN