Healthcare Provider Details

I. General information

NPI: 1598784118
Provider Name (Legal Business Name): MICHAEL A DEL TORTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 MARVEL CT
EASTON MD
21601-4053
US

IV. Provider business mailing address

403 MARVEL CT
EASTON MD
21601-4053
US

V. Phone/Fax

Practice location:
  • Phone: 410-819-8867
  • Fax: 410-822-0416
Mailing address:
  • Phone: 410-819-8867
  • Fax: 410-822-0416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0059921
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: