Healthcare Provider Details

I. General information

NPI: 1669424834
Provider Name (Legal Business Name): DRESNICK/STERLING PEDIATRIC SERVICES OF MARYLAND, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UPPER CHESAPEAKE DR
BEL AIR MD
21014-4324
US

IV. Provider business mailing address

6400 ATLANTIC BLVD
JACKSONVILLE FL
32211-8768
US

V. Phone/Fax

Practice location:
  • Phone: 443-643-1000
  • Fax:
Mailing address:
  • Phone: 904-805-1300
  • Fax: 904-805-1456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN J DRESNICK
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 904-805-1300