Healthcare Provider Details

I. General information

NPI: 1356491450
Provider Name (Legal Business Name): STEPHEN MICHAEL CATTANEO II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 11/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 MEDICAL PKWY SUITE 301
ANNAPOLIS MD
21401-7992
US

IV. Provider business mailing address

PO BOX 12622
BELFAST ME
04915-4017
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-3300
  • Fax:
Mailing address:
  • Phone: 443-481-6538
  • Fax: 443-481-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberD0055731
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: