Healthcare Provider Details

I. General information

NPI: 1245736743
Provider Name (Legal Business Name): CAREY STUART POLITZER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10215 FERNWOOD RD STE 506
BETHESDA MD
20817-1184
US

IV. Provider business mailing address

1810 STATE ST APT 602
SAN DIEGO CA
92101-2999
US

V. Phone/Fax

Practice location:
  • Phone: 301-530-1010
  • Fax: 301-897-8597
Mailing address:
  • Phone: 484-332-1511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberD0100563
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: