| Organization Name: | MEDSTAR MEDICAL GROUP II LLC |
| NPI Number: | 1184046187 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHANIE SCHNEIDER (VP) |
| Mailing Address: | 5601 Loch Raven Blvd Russell Morgan Bldg 3rd Fl Baltimore |
| State: | MD US |
| Postal Code: | 212392945 |
| Phone Number: | 4434445606 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2014 |
| NPI Last Update Date: | 05/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |