Provider Demographics
NPI:1356446272
Name:WARRES, STEPHEN ELLIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ELLIOT
Last Name:WARRES
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 1:7601 TRAVERTINE DRIVE, UNIT 204
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-5322
Mailing Address - Country:US
Mailing Address - Phone:443-744-1450
Mailing Address - Fax:877-991-4844
Practice Address - Street 1:711 W 40TH ST
Practice Address - Street 2:SUITE 318A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2120
Practice Address - Country:US
Practice Address - Phone:410-235-1800
Practice Address - Fax:410-235-5557
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00206642084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM10816OtherDIVISION OF DRUG CONTROL
MDM10816OtherDIVISION OF DRUG CONTROL
B70506Medicare UPIN