Individual
STACEY T. NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7141 SECURITY BLVD, BALTIMORE, MD 21244-1811
(443) 663-6015
(443) 663-6302
Mailing address
7141 SECURITY BLVD, BALTIMORE, MD 21244-1811
(443) 663-6485
(443) 663-6026
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0060929
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212150600
—
MD
01
—
550686
VALUE OPTIONS PROVIDER #
MD
01
—
64758601
MD RENDERING #
MD
01
—
814276000
MIS #
MD
01
—
T5140019
CAREFIRST REGIONAL PAR#
MD
Enumeration date
07/27/2006
Last updated
06/22/2021
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