| Doctor Name: | DR. GARY S STAPLES |
| NPI Number: | 1285620401 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | D0018817 |
| Business Practice Address: | 7501 Surratts Rd Clinton, MD - 207353362 |
| Business Phone Number: | 3018707001 |
| Business Fax Number: | 3018706697 |
| Mailing Address: | 7503 Surratts Rd, CLINTON |
| State: | MD |
| Postal Code: | 207353358 |
| Phone Number: | 3018707001 |
| Fax Number: | 3018706697 |
| NPI Enumeration Date: | 09/22/2005 |
| NPI Last Update Date: | 03/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 09/24/2009 |
| NPI Reactivation Date: | 03/22/2013 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | D0018817 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |