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1356303630
JEFFREY L STARK
RANDALLSTOWN, MD
NPI
1356303630
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: MD C00511)
Enumeration Date
2006-04-04
Last Update Date
2007-11-29
Business Address
Mr. JEFFREY L STARK PA-C
5401 OLD COURT RD
RANDALLSTOWN, MD 21133-5103
Phone number: 410-521-2200
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Mailing Address
Mr. JEFFREY L STARK PA-C
5401 OLD COURT RD ATTN: CREDENTIALING
RANDALLSTOWN, MD 21133-5103
Phone number: 410-601-5524
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