Organization
PARKVILLE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRY LYNN STEVENSON CRNP (MANAGING MEMBER/PROVIDER)
(410) 371-3373
Entity
Organization
Contact information
Practice address
1721 BELFAST RD, SPARKS, MD 21152-9786
(410) 371-3373
Mailing address
1721 BELFAST RD, SPARKS, MD 21152-9786
(410) 371-3373
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
605M957F
—
MD
Enumeration date
03/06/2019
Last updated
03/07/2023
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