Provider Demographics
NPI:1275987901
Name:REGENOLD, STEPHANIE STRAUSS (MD, MPH)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:STRAUSS
Last Name:REGENOLD
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 N CHARLES ST STE A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2642
Mailing Address - Country:US
Mailing Address - Phone:410-617-5055
Mailing Address - Fax:410-617-2173
Practice Address - Street 1:4502 N CHARLES ST STE A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2642
Practice Address - Country:US
Practice Address - Phone:410-617-5055
Practice Address - Fax:410-617-2173
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine