Individual
STACEY LAURINE EADIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1105 N POINT BLVD, SUITE 306, BALTIMORE, MD 21224-3419
(410) 285-5437
(410) 285-7333
Mailing address
PO BOX 15444, BALTIMORE, MD 21220-0444
(410) 285-5437
(410) 285-7333
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H0061035
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001285800
MEDICAL ASSISTANCE
MD
Enumeration date
03/03/2006
Last updated
11/05/2014
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