| Dr. Stephen Witanowski | |
|
2700 Quarry Lake Dr Suite 280 Baltimore MD 21209-3742 | |
| (410) 469-5544 | |
| (410) 585-2867 |
| Full Name | Dr. Stephen Witanowski |
|---|---|
| Speciality | Internal Medicine |
| Location | 2700 Quarry Lake Dr, Baltimore, Maryland |
| Authorized Official Name and Position | Mary Wright-sisk (DIRECTOR OF PHYSICIAN ENTERPRISE) |
| Authorized Official Contact | 4434229941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Stephen Witanowski 5401 Old Court Rd Randallstown MD 21133-5103 Ph: (410) 701-4439 | Dr. Stephen Witanowski 2700 Quarry Lake Dr Suite 280 Baltimore MD 21209-3742 Ph: (410) 469-5544 |
| NPI Number | 1366807885 |
|---|---|
| Provider Enumeration Date | 12/29/2015 |
| Last Update Date | 08/27/2021 |
| Certification Date | 08/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366807885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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Fresh Start Comprehensive Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 E Mount Royal Ave # Ll, Baltimore, MD 21202 Phone: 443-671-1414 Fax: 443-671-1420 |
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