Provider Demographics
NPI:1023019395
Name:HITTMAN, STEPHEN JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:HITTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5803
Mailing Address - Country:US
Mailing Address - Phone:410-787-4000
Mailing Address - Fax:410-595-1914
Practice Address - Street 1:301 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5803
Practice Address - Country:US
Practice Address - Phone:410-787-4000
Practice Address - Fax:410-595-1914
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH35612208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD425489-02OtherCAREFIRST MD RENDERING
MD7605-0004OtherCAREFIRST BLUECHOICE
MD1321285OtherCIGNA PIN
MD235457OtherMAMSI SPECIALIST
MDP11954OtherCAREFIRST MPOS
MD370006855OtherRR MEDICARE
MD4231392OtherAETNA FEE FOR SERVICE
MD835457OtherMAMSI PRIMARY CARE
MD0100199OtherAETNA CAPITATED
MD017880OtherJHHC PROVIDER NUMBER
MD548581900Medicaid
MD0100199OtherAETNA CAPITATED
MD226L298BMedicare PIN