Individual
DR. JESSIE DOUKAS STAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE, PAVILION 1ST FLOOR, BALTIMORE, MD 21224-2735
(410) 550-0212
(410) 550-1264
Mailing address
PO BOX 64358, BALTIMORE, MD 21264-4358
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0019978
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1309401400
—
MD
01
—
2849
B/C B/S
DC
05
—
309401400
—
MD
01
—
J062
B/C B/S
MD
01
—
KA80
B/C B/S
MD
Enumeration date
03/29/2006
Last updated
02/01/2013
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