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NPI Code Detail

MEDICARE: DR. SAMUEL B ITSCOITZ MD

MEDICARE: DR. SAMUEL B ITSCOITZ MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianD0005568MD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
8CM6438OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10787143OTHERAETNA
224324OTHERMAMSI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
44086234OTHERUNITED HEALTH CARE
5KA62ITOTHERBLUE CROSS MD
658030002OTHERBLUE CROSS DC
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760587596
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL B ITSCOITZ MD
Provider Business Mailing Address
First Line : 3100 WYMAN PARK DR
Second Line :
City : BALTIMORE
State : MD
Zip : 21211-2803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12070 OLD LINE CTR STE 303
Second Line :
City : WALDORF
State : MD
Zip : 20602-3535
Country : US
Telephone Number : 301-645-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 01/04/2019

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Directions to “ DR. SAMUEL B ITSCOITZ MD” Practice Location

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