Healthcare Provider Details

I. General information

NPI: 1356511737
Provider Name (Legal Business Name): REGIS STORCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 01/11/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27734 WAVERLY RD
EASTON MD
21601-8120
US

IV. Provider business mailing address

27734 WAVERLY RD
EASTON MD
21601-8120
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-5519
  • Fax:
Mailing address:
  • Phone: 410-822-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD10760
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: