Provider Demographics
NPI:1356433403
Name:STINSON AND GRECO MD, PA
Entity type:Organization
Organization Name:STINSON AND GRECO MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STINSON
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:301-896-2012
Mailing Address - Street 1:PO BOX 630514
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-0514
Mailing Address - Country:US
Mailing Address - Phone:800-392-3011
Mailing Address - Fax:585-359-3353
Practice Address - Street 1:6420 ROCKLEDGE DR
Practice Address - Street 2:SUITE 1200
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7837
Practice Address - Country:US
Practice Address - Phone:301-896-2012
Practice Address - Fax:301-897-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD3131655OtherAETNA GROUP #
MD4342224-00Medicaid
MD90001OtherNCPPO GROUP #
MD220700OtherMAMSI GROUP #
DC0344293-00Medicaid
MDKAU7MEOtherMD CAREFIRST BC/BS GRP #
DCS357OtherDC CAREFIRST BC/BS GRP #
MD3131655OtherAETNA GROUP #