Individual
DR. STEPHANIE B. CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
238 MERRIMAC CT, PRINCE FREDERICK, MD 20678-6113
(410) 535-0892
(410) 535-5677
Mailing address
PO BOX 838, PRINCE FREDERICK, MD 20678-0838
(410) 535-0892
(410) 535-5677
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01069672A
IN
207R00000X
Internal Medicine Physician
11014288A
IN
207R00000X
Internal Medicine Physician
Primary
D74973
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000725822
ANTHEM PIN
IN
05
—
201029140
—
IN
05
—
599308300
—
MD
01
—
P00982678
RR MEDICARE
IN
Enumeration date
06/17/2008
Last updated
02/02/2017
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