Healthcare Provider Details

I. General information

NPI: 1982698973
Provider Name (Legal Business Name): STEPHEN H POLLOCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 OSLER DR SUITE 403
BALTIMORE MD
21204-7736
US

IV. Provider business mailing address

PO BOX 79944
BALTIMORE MD
21279-0944
US

V. Phone/Fax

Practice location:
  • Phone: 410-427-2580
  • Fax:
Mailing address:
  • Phone: 410-337-1554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0019236
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberD0019236
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: