Provider Demographics
NPI:1477555134
Name:RESNICK, STEVEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:RESNICK
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 1:2000 MEDICAL PKWY
Mailing Address - Street 2:SUITE 607
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3742
Mailing Address - Country:US
Mailing Address - Phone:410-266-1644
Mailing Address - Fax:410-266-1642
Practice Address - Street 1:2000 MEDICAL PKWY
Practice Address - Street 2:SUITE 607
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3742
Practice Address - Country:US
Practice Address - Phone:410-266-1644
Practice Address - Fax:410-266-1642
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035494207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCL4599 P00006102OtherRAILROAD MEDICARE
MD269900101 385710700Medicaid
MDCL4599 P00006102OtherRR MEDICARE
DCS3520013OtherCAREFIRST BCBS
MDKJ86AN 54438203OtherCAREFIRST BCBS
MDP00917250OtherMEDICARE RAILROAD
MDF11867Medicare UPIN
MD691LF630Medicare PIN