Provider Demographics
NPI:1992773618
Name:VALENTI, STEPHEN ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ANTHONY
Last Name:VALENTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ANNE LANE
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2638
Mailing Address - Country:US
Mailing Address - Phone:410-693-2770
Mailing Address - Fax:
Practice Address - Street 1:1 ANNE LANE
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2638
Practice Address - Country:US
Practice Address - Phone:410-693-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD22681174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0061936OtherAETNA
MDP00908425OtherRAILROAD MEDICARE
MD310781700Medicaid
MD366860-05OtherCAREFIRST OF MARYLAND
MDV879-0008OtherCAREFIRST GHMSI AND BLUE CHOICE
MD366860-05OtherCAREFIRST OF MARYLAND
MDP00908425OtherRAILROAD MEDICARE