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NPI Code Detail

MEDICARE: DR. STEPHEN JAMES TITUS M.D.

MEDICARE:  DR. STEPHEN JAMES TITUS  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
1207Q00000XFamily Medicine Physician01057620AIN

General Provider Information

NPI Number : 1710078001
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN JAMES TITUS M.D.
Provider Business Mailing Address
First Line : 14113 RECTORY LN
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20772-2827
Country : US
Telephone Number : 240-857-3956
Fax Number :
Provider Business Practice Location Address
First Line : 1050 W PERIMETER RD
Second Line :
City : ANDREWS AIR FORCE BASE
State : MD
Zip : 20762-6601
Country : US
Telephone Number : 240-857-3956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 04/12/2022

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