Provider Demographics
NPI:1528289899
Name:STEPHEN KATZ MD PA
Entity type:Organization
Organization Name:STEPHEN KATZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-544-5901
Mailing Address - Street 1:31 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2841
Mailing Address - Country:US
Mailing Address - Phone:410-544-5901
Mailing Address - Fax:410-544-5939
Practice Address - Street 1:31 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2841
Practice Address - Country:US
Practice Address - Phone:410-544-5901
Practice Address - Fax:410-544-5939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD38687207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS71328Medicare UPIN
MDE39454Medicare UPIN
MDQ41670Medicare UPIN