Individual
PENELOPE STAMMER DOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
130 HOLIDAY CT, SUITE 109, ANNAPOLIS, MD 21401-7003
(410) 266-0099
(410) 266-8629
Mailing address
130 HOLIDAY CT, ANNAPOLIS, MD 21401-7003
(410) 266-0099
(410) 266-8629
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1038
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3019295
AETNA HMO
MD
01
—
313067
OPTIMUM CHOICE/MDIPA
MD
01
—
5851409
AETNA PPO
MD
01
—
61045001
BCBS
MD
01
—
F038
BCBS
DC
01
—
TA1038
LICENSE
MD
Enumeration date
06/04/2006
Last updated
09/05/2007
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