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General NPI Number Information
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NPI Number | 1992882252
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Entity Type | Individual
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Provider Name | MARK STUART DILLS PA
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3001 HOSPITAL DR
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City | CHEVERLY
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State | MD
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Zip | 20785-1189
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Country | US
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Telephone | 301-618-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 397 BALTIMORE ANNAPOLIS BLVD
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City | SEVERNA PARK
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State | MD
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Zip | 21146-1371
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Country | US
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Telephone | 410-544-7295
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0000350
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License Number State | MD
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