CARL E STAFSTROM (NPI# 1912979196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912979196 |
| Entity Type | Individual |
| Full Name | CARL E STAFSTROM |
| Credential | MD PHD |
| Practice Address |
200 N Wolfe St Baltimore MD 21287-0011 |
| Mailing Address |
Po Box 64227 Baltimore MD 21264-4264 |
| Practice Telephone | 4109554259 |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2014-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 41489 | WI | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
41489 | WI | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
D77086 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 073165000 | 05 |
| Street Address |
200 N WOLFE ST |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21287-0011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528537305 | Oren Gordon | Student in an Organized Health Care Education/Training Program | 200 N Wolfe St, Baltimore, MD 21287-0011 | 2018-11-21 |
| 1285155333 | Kelsey Stauff | Student in an Organized Health Care Education/Training Program | 200 N Wolfe St, Baltimore, MD 21287-0011 | 2017-06-29 |
| 1518403245 | Donna Shatzer | Nurse Practitioner | 200 N Wolfe St, Baltimore, MD 21287-0011 | 2017-01-19 |
| 1922461714 | Jacquelyn Manfredo | Student in an Organized Health Care Education/Training Program | 200 N Wolfe St, Baltimore, MD 21287-0011 | 2016-03-30 |
| 1659753903 | Amanda Regina Wood | Nurse Practitioner | 200 N Wolfe St, Suite 2158, Baltimore, MD 21287-0011 | 2015-06-23 |
| 1871970301 | Mark Porter | Student in an Organized Health Care Education/Training Program | 200 N Wolfe St, Baltimore, MD 21287-0011 | 2015-05-05 |
| 1841600087 | Francis Tintani | Student in an Organized Health Care Education/Training Program | 200 N Wolfe St, Suite 2-111, Baltimore, MD 21287-0011 | 2014-04-28 |
| 1861819039 | Brandon Michael Smith | Pediatrics | 200 N Wolfe St, Baltimore, MD 21287-0011 | 2014-03-25 |
| 1437418670 | Tierra D. Burrell | Pediatrics | 200 N Wolfe St, Baltimore, MD 21287-0011 | 2012-05-09 |
| 1265716005 | Eric Douglass Mccollum | Pediatrics | 200 N Wolfe St, Suite 3015, Baltimore, MD 21287-0011 | 2011-09-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140503 | Thomas Dimitrios Zaikos | Student in an Organized Health Care Education/Training Program | Pathology Building Rm. 401, 600 N. Wolfe Street, Baltimore, MD 21287 | 2020-07-01 |
| 1316572175 | Sarah Branigan | Pediatrics | Johns Hopkins Children's Center, 1800 Orleans Street, Baltimore, MD 21287 | 2020-03-11 |
| 1790318657 | Margaret Geraldine Keane | Internal Medicine | Sheikh Zayed Tower, 1800 Orleans St, Baltimore, MD 21287 | 2020-02-19 |
| 1699322636 | Lakeya Mcgill | Student in an Organized Health Care Education/Training Program | 600 North Wolfe St, Phipps 174, Baltimore, MD 21287 | 2019-08-23 |
| 1245882406 | Ranim Amer Ibrahim Alsaad | Student in an Organized Health Care Education/Training Program | 1800 Orleans Street - Johns Hopkins Hospital, Tower 110, Baltimore, MD 21287 | 2019-07-09 |
| 1992364004 | Anthony David Pisaniello | Student in an Organized Health Care Education/Training Program | 1800 Orleans St, Johns Hopkins Hospital, Baltimore, MD 21287 | 2019-06-12 |
| 1255990503 | Ethan Tumarkin | Student in an Organized Health Care Education/Training Program | 600 N. Wolfe St./halsted 500, Baltimore, MD 21287 | 2019-06-11 |
| 1629636386 | Kathleen Anne Malloy | Counselor | Jhh 600 N. Wolfe St., Cpp- Meyer 144, Baltimore, MD 21287 | 2019-05-29 |
| 1285298489 | Ashleigh Graham | Student in an Organized Health Care Education/Training Program | Pathology Building, Rm 401, 600 N. Wolfe Street, Baltimore, MD 21287 | 2019-04-24 |
| 1851955066 | Seena Tabibi | Student in an Organized Health Care Education/Training Program | Pathology Department Johns Hopkins University Som, Pathology Building Rm 401, 600 North Wolfe Street, Baltimore, MD 21287 | 2019-04-24 |
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| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063559268 | Kristin Whitford Baranano | Psychiatry & Neurology | 9910 Franklin Square Dr. Suite 2060, Johns Hopkins University- Clinical Practice Association, Baltimore, MD 21236-4902 | 2007-01-30 |
| 1528068939 | Joseph Scheller | Psychiatry & Neurology | 2501 Willow Glen Dr, Baltimore, MD 21209-3106 | 2005-07-28 |
| 1578957130 | Laura Malone | Psychiatry & Neurology | 1800 Orleans St Rm 8446, Baltimore, MD 21287-0010 | 2015-03-22 |
| 1457798290 | Juan Alfredo Caceres Noguera | Psychiatry & Neurology | 2401 W Belvedere Ave, Baltimore, MD 21215-5216 | 2013-06-03 |
| 1508108879 | Sinai Hospital of Baltimore, Inc | Psychiatry & Neurology | 2435 W Belvedere Ave, Suite 32, Baltimore, MD 21215-5224 | 2013-03-25 |
| 1467746156 | Samata Singhi | Psychiatry & Neurology | 600 N Wolfe Street, Meyer 2-147, Baltimore, MD 21287-0005 | 2011-05-31 |
| 1689972523 | Verena Staedtke | Psychiatry & Neurology | Johns Hopkins Hospital Department Of, 200 N Wolfe Street, Suite 2158, Baltimore, MD 21287-0001 | 2011-03-01 |
| 1083939326 | Jacqueline Harris | Psychiatry & Neurology | 707 N Broadway, Baltimore, MD 21205-1888 | 2010-03-30 |
| 1972833994 | Lisa Renee Sun | Psychiatry & Neurology | 1800 Orleans St, Room 8444, Baltimore, MD 21287-0010 | 2010-01-14 |
| 1487851721 | Ryan Felling | Psychiatry & Neurology | 200 N Wolfe St, Harriet Lane, Suite 2158, Baltimore, MD 21287-0011 | 2007-06-29 |
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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.