MEDICARE: DR. JANICE F. RUTKOWSKI M.D.

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
1	207R00000X	Internal Medicine Physician	D0027513	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	110179667	OTHER	MD	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	420210-10	OTHER	MD	CAREFIRST MD RENDERING
2	7605-0030	OTHER	MD	CAREFIRST BLUECHOICE
3	8163609	OTHER	MD	MAMSI PRIMARY CARE
4	0000611	OTHER	MD	AETNA CAPITATED
5	2163609	OTHER	MD	MAMSI SPECIALIST
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	P12793	OTHER	MD	CAREFIRST MPOS
8	036584	OTHER	MD	JHHC PROVIDER NUMBER
10	4137394	OTHER	MD	AETNA FEE FOR SERVICE
11	1402555	OTHER	MD	CIGNA PIN

General Provider Information

NPI Number	:	1326030214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE F. RUTKOWSKI M.D.

Provider Business Mailing Address
First Line	:	7580 BUCKINGHAM BLVD
Second Line	:	SUITE 220
City	:	HANOVER
State	:	MD
Zip	:	21076-3002
Country	:	US
Telephone Number	:	410-729-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	7556 TEAGUE RD.
Second Line	:	SUITE 210
City	:	HANOVER
State	:	MD
Zip	:	21076
Country	:	US
Telephone Number	:	410-551-0499
Fax Number	:	410-799-9070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	04/11/2020

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