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NPI Code Detail

MEDICARE: DR. AMEYA UMAKANT AMRITWAR MD

MEDICARE: DR. AMEYA UMAKANT AMRITWAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084A0401XAddiction Medicine (Psychiatry & Neurology) PhysicianD0082940MD

General Provider Information

NPI Number : 1023445772
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMEYA UMAKANT AMRITWAR MD
Provider Business Mailing Address
First Line : 4100 COLLEGE AVE
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-5506
Country : US
Telephone Number : 443-364-5500
Fax Number :
Provider Business Practice Location Address
First Line : 4100 COLLEGE AVE
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-5506
Country : US
Telephone Number : 443-613-9906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2013
Last Update Date : 11/12/2019

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