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Individual
MARY JEAN STARK
Active
Individual
MARY JEAN STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA003135L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03246701
CAPITAL BLUE CROSS
PA
01
—
P00791043
RAILROAD MEDICARE
—
Enumeration date
03/29/2006
Last updated
07/08/2026
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