Edward John Distelhorst, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

D0022107 Issued in MD

Practice address

700 Melvin Ave
Suite 7a
Annapolis, MD 21401-1514

Phone

(410) 280-2260

NPI assigned

Jun 24, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Anesthesia Company, LLC

  • Anesthesiology Physician
  • Annapolis, MD
  • NPI 1871548156
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1821024423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MELVIN AVE",
            "address_2": "SUITE 7A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011514",
            "telephone_number": "410-280-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTELHORST",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0022107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lara L Dimick-Santos, MD
• Laura Dingess, RBT
• Russel Dinh, MD
• Pamela S Dinkel
• Lucia Dirado
• Jason R. Dittrich, M.D.
• Divine Dental Annapolis
• Alexus Dixon
• Teresa Elizabeth Dixon, SLP
• Megan Marie Dixson, D.D.S.

• Anesthesiology Physician in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Anesthesiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.