Healthcare Provider Details

I. General information

NPI: 1912264441
Provider Name (Legal Business Name): KATHERINE STOLARZ D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2012
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 FRANKLIN SQUARE DR STE 300
BALTIMORE MD
21237-3966
US

IV. Provider business mailing address

9101 FRANKLIN SQUARE DR STE 300
BALTIMORE MD
21237-3966
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-2000
  • Fax: 866-857-9388
Mailing address:
  • Phone: 443-777-2000
  • Fax: 866-857-9388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH0079549
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: