Individual
MARK STAMOWLAROS
Active
Individual
MARK STAMOWLAROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R045868
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104829
—
AL
05
—
242130099
—
ME
05
—
307975900
—
FL
01
—
592-03334
BLUE CROSS BLUE SHIELD
AL
01
—
G4098
BLUE CROSS BLUE SHIELD
FL
01
—
P00151925
RAILROAD MEDICARE
—
Enumeration date
08/16/2006
Last updated
06/16/2009
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