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General NPI Number Information
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NPI Number | 1275987901
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Entity Type | Individual
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Provider Name | STEPHANIE STRAUSS REGENOLD M.D., M.P.H.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 4502 N CHARLES ST STE A
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City | BALTIMORE
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State | MD
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Zip | 21210-2642
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Country | US
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Telephone | 410-617-5055
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Fax | 410-617-2173
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Provider Business Mailing Address
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Address Line | 4502 N CHARLES ST STE A
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City | BALTIMORE
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State | MD
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Zip | 21210-2642
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Country | US
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Telephone | 410-617-5055
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Fax | 410-617-2173
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0041148
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License Number State | MD
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