Stephen John Witanowski, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0080458 Issued in MD

Practice address

2700 Quarry Lake Dr
Suite 280
Baltimore, MD 21209-3742

Phone

(410) 469-5544

Fax

(410) 585-2867

NPI assigned

May 9, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment NPD
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Lifebridge Community Physicians, Inc

  • Pulmonary Disease Physician
  • Pikesville, MD
  • NPI 1306182621
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1003040726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR",
            "address_2": "SUITE 280",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093742",
            "telephone_number": "410-469-5544",
            "fax_number": "410-585-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR",
            "address_2": "SUITE 280",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093742",
            "telephone_number": "410-469-5544",
            "fax_number": "410-585-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITANOWSKI",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-09",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0080458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Catherine Wisniewski, LMSW
• Carolyn R Wisniewski, C.R.N.P.
• Emily Wisniewski, M.D.
• Julia A. Wisniewski, M.D.
• Cody Michael Wisnom, DDS
• Kristina Grace Witcher, MD
• With Grace Supportive Living
• With Love Assisted Living and Adult Care Limited Liability Company
• Aniya Witherspoon
• Charmaine Witherspoon

• Internal Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.