Detterline, Stephanie
Detterline, Stephanie is an individual health care provider with primary practice located at 201 E University Pkwy 33Rd St. Professional Bldg, Ste 405, Baltimore MD 21218-2829. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Detterline, Stephanie can be contacted via phone (410) 554-2284.Contact Information
Primary practice address
201 E University Pkwy 33Rd St. Professional Bldg, Ste 405
Baltimore MD 21218-2829
Phone: (410) 554-2284
Fax: (410) 554-2184
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 36113740 | Illinois |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 036113740 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35089436 | Ohio |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 35089436 | Ohio |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | D67439 | Maryland |
Profile Details
| NPI number | 1104890367 |
|---|---|
| LBN Legal business name | Detterline, Stephanie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Nov 21st, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104890367 | NPPES |
| Kentucky | MEDICAID | 7100007510 | |
| Kentucky | MEDICAID | 2745748 | |
| Kentucky | MEDICAID | 36113740 | |
| Kentucky | MEDICAID | 200867020 |
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