Provider Demographics
NPI:1093887036
Name:AMITIN, SIGMUND ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:SIGMUND
Middle Name:ALLEN
Last Name:AMITIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 WEST ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3662
Mailing Address - Country:US
Mailing Address - Phone:410-269-0670
Mailing Address - Fax:
Practice Address - Street 1:1203 WEST ST
Practice Address - Street 2:SUITE C
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3662
Practice Address - Country:US
Practice Address - Phone:410-269-0670
Practice Address - Fax:410-263-1042
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD 182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB70299Medicare UPIN