NORMAN RUSSELL STACKHOUSE (NPI# 1053412569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053412569 |
| Entity Type | Individual |
| Full Name | NORMAN RUSSELL STACKHOUSE |
| Credential | P.A. |
| Practice Address |
9131 Piscataway Rd Suite 600 Clinton MD 20735-2508 |
| Practice Telephone | 3018680110 |
| Practice Fax Number | 3018560604 |
| Mailing Telephone | 3018680110 |
| Mailing Fax Number | 3018560604 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C0000861 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9131 PISCATAWAY RD SUITE 600 |
| City | CLINTON |
| State | MD |
| Zip Code | 20735-2508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235122680 | Patrick Haugh | Specialist | 9131 Piscataway Rd, Suite 620, Clinton, MD 20735-2508 | 2005-08-31 |
| 1366057523 | Prince George's County Health Department | Public Health or Welfare | 9131 Piscataway Rd, Clinton, MD 20735-2508 | 2020-09-14 |
| 1659835684 | Rosemond Dickson Bartels, Crnp, LLC | Obstetrics & Gynecology | 9131 Piscataway Rd, Clinton, MD 20735-2508 | 2019-01-23 |
| 1497124796 | Myeyedr Optometry of Maryland, LLC | Optometrist | 9131 Piscataway Rd, Ste 120, Clinton, MD 20735-2508 | 2015-09-17 |
| 1235450099 | Herman Daniels | Internal Medicine | 9131 Piscataway Rd, 430, Clinton, MD 20735-2508 | 2010-06-16 |
| 1386976512 | Woman To Woman Obgyn PC | Specialist | 9131 Piscataway Rd, Suite 540, Clinton, MD 20735-2508 | 2010-02-15 |
| 1891932554 | Joseph Maloney | Dentist | 9131 Piscataway Rd, Suite 739, Clinton, MD 20735-2508 | 2009-01-15 |
| 1699921411 | George E. Urban, Jr Md Pa | Otolaryngology | 9131 Piscataway Rd, Suite 410, Clinton, MD 20735-2508 | 2008-08-12 |
| 1205082245 | Vanessa Kay Gordon | Dentist | 9131 Piscataway Rd, Suite 210, Clinton, MD 20735 | 2008-08-11 |
| 1568621456 | Shalom Pharmacy | Durable Medical Equipment & Medical Supplies | 9131 Piscataway Rd, Ste 260, Clinton, MD 20735-2508 | 2008-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940456 | Elise Olson | Occupational Therapist | 9135 Piscataway Rd, Suite 305, Clinton, MD 20735 | 2019-03-12 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1386193233 | Benedicta C Osamor | Home Health Aide | 6808 Purple Lilac Ln, Clinton, MD 20735 | 2016-10-03 |
| 1669926309 | Frankline Ngozi Obi I | Home Health Aide | 8111 Highland Meadows Dr, Clinton, MD 20735 | 2016-08-11 |
| 1770952459 | Adventures One, Inc. | Clinic/Center | 7121 Old Alexandria Ferry Rd., Clinton, MD 20735 | 2015-09-23 |
| 1730574831 | Lindsey Degeorge | Emergency Medicine | 7503 Surratts Rd Dept Of, Clinton, MD 20735 | 2015-04-06 |
| 1316341860 | Margaret Laurence-whitlock | Speech-Language Pathologist | 5807 Terence Dr., Laurence Learning Center, Clinton, MD 20735 | 2014-10-13 |
| 1699103622 | Dcps | Social Worker | 5504 Trout Run Rd, Clinton, MD 20735 | 2013-10-30 |
| 1902232614 | Rafael Antonio Acosta | Dentist | 7905 Malcolm Rd Ste 300, Clinton, MD 20735 | 2013-09-25 |
| 1407135874 | Richelle Wilson Harvey | Occupational Therapist | 8202 Shackelford Way, Clinton, MD 20735 | 2011-08-16 |
| Find all providers in zip 20735 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336617059 | Micaela L Goebel | Physician Assistant | 120 Tanner Pl Bldg H, Clinton, TN 37716-6684 | 2018-11-12 |
| 1407944721 | Brent Ashley Westbrook | Physician Assistant | 48 Stillwater Ln, Clinton, NC 28328-6119 | 2006-10-11 |
| 1699881219 | Heather Lynn Beck | Physician Assistant | 10401 Hospital Dr Ste 101, Clinton, MD 20735-3150 | 2006-08-23 |
| 1760042782 | Alexandra Jo Burrini | Physician Assistant | 59 Old Highway 22, Clinton, NJ 08809-1342 | 2019-06-20 |
| 1801349279 | Sara Cobb | Physician Assistant | 59 Old Highway 22, Clinton, NJ 08809-1342 | 2016-08-02 |
| 1861844979 | Will Godfrey | Physician Assistant | 22725 Highway 76 E, Clinton, SC 29325-7527 | 2016-07-13 |
| 1538526959 | Suzzette Van-lare | Physician Assistant | 7503 Surratts Rd, Clinton, MD 20735-3358 | 2016-01-16 |
| 1811371685 | Dermone | Physician Assistant | 603 Beaman St, Clinton, NC 28328-2650 | 2015-07-12 |
| 1477940898 | Melissa Weeter | Physician Assistant | 7503 Surratts Rd, Clinton, MD 20735-3358 | 2015-04-23 |
| 1982097085 | Mirella Cortez | Physician Assistant | 7503 Surratts Rd, Clinton, MD 20735-3358 | 2015-03-13 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.