Provider Demographics
NPI:1043235310
Name:STOLTZ, ROBERT BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BENJAMIN
Last Name:STOLTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1447 YORK RD
Mailing Address - Street 2:SUITE 605
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6017
Mailing Address - Country:US
Mailing Address - Phone:410-821-1300
Mailing Address - Fax:410-821-0201
Practice Address - Street 1:1447 YORK RD
Practice Address - Street 2:SUITE 605
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6017
Practice Address - Country:US
Practice Address - Phone:410-821-1300
Practice Address - Fax:410-821-0201
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD30910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8387Medicare UPIN