Individual
MS. STEPHANIE BRANCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
11110 MALL CIRCLE, SUITE 2001, WALDORF, MD 20603
(301) 705-8451
(301) 705-8448
Mailing address
11110 MALL CIRCLE, SUITE 2001, P.O. BOX 6210, WALDORF, MD 20603
(301) 705-8451
(301) 705-8448
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1005
MD
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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