Individual provider · Type 1 NPI

Jeffrey L. Stark, PA-C

Surgical Physician Assistant · Randallstown, MD

NPI number 1356303630 Active

Practice location

5401 Old Court Rd
Randallstown, MD 21133-5103

Call (410) 521-2200 Map

Fax (410) 922-6031

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XC00511 (MD)

Surgical Physician Assistant: Definition to come...

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About NPI 1356303630

Jeffrey L. Stark, PA-C's National Provider Identifier is 1356303630, issued on Apr 4, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Randallstown, MD. The record was last updated on Nov 29, 2007.