Healthcare Provider Details

I. General information

NPI: 1356446272
Provider Name (Legal Business Name): STEPHEN ELLIOT WARRES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 40TH ST SUITE 318A
BALTIMORE MD
21211-2120
US

IV. Provider business mailing address

7601 TRAVERTINE DRIVE, UNIT 204
BALTIMORE MD
21209-5322
US

V. Phone/Fax

Practice location:
  • Phone: 410-235-1800
  • Fax: 410-235-5557
Mailing address:
  • Phone: 443-744-1450
  • Fax: 877-991-4844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0020664
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0020664
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: