Provider Demographics
NPI:1285634238
Name:REINITZ, STEPHEN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:REINITZ
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 1:3001 SOUTH HANOVER STREET
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21226
Mailing Address - Country:US
Mailing Address - Phone:410-350-3341
Mailing Address - Fax:410-354-0170
Practice Address - Street 1:3001 SOUTH HANOVER STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21226
Practice Address - Country:US
Practice Address - Phone:410-350-3341
Practice Address - Fax:410-354-0170
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00041591207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD648471900Medicaid
E94612Medicare UPIN
MD648471900Medicaid