Individual
STANLEY JOHN PODLASEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5755 CEDAR LN, COLUMBIA, MD 21044-2912
(410) 740-7852
Mailing address
PO BOX 64478, BALTIMORE, MD 21264-4478
(410) 933-1265
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D32592
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232300100
—
MD
Enumeration date
06/04/2006
Last updated
01/31/2013
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