Provider Demographics
NPI:1861783391
Name:RODWELL, STEFANIE M (MD)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:M
Last Name:RODWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6565 N CHARLES ST STE 406
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5803
Mailing Address - Country:US
Mailing Address - Phone:443-849-2568
Mailing Address - Fax:443-849-2939
Practice Address - Street 1:6565 N CHARLES ST STE 406
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-5803
Practice Address - Country:US
Practice Address - Phone:443-849-2568
Practice Address - Fax:443-849-2939
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0082310207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty