Individual
MR. MICHAEL SHAWN STOCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
440 KOONCE RD, HARPERS FERRY, WV 25425-3126
(304) 724-5918
(304) 724-5920
Mailing address
5408 BARTONSVILLE RD, FREDERICK, MD 21704-6802
(301) 694-0715
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R073180
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00748732
—
MD
Enumeration date
06/16/2005
Last updated
10/20/2009
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