Healthcare Provider Details

I. General information

NPI: 1346212560
Provider Name (Legal Business Name): STUART ALAN RABINOWITZ M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CROSSROADS DR STE 100
OWINGS MILLS MD
21117-5441
US

IV. Provider business mailing address

7253 AMBASSADOR RD
BALTIMORE MD
21244-2710
US

V. Phone/Fax

Practice location:
  • Phone: 410-356-8186
  • Fax: 410-356-4180
Mailing address:
  • Phone: 443-436-1116
  • Fax: 443-436-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberD0033107
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberD0033107
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: