Provider Demographics
NPI:1609826536
Name:DRESNICK STERLING EMERGENCY PHYSICIANS OF MARYLAND PA
Entity Type:Organization
Organization Name:DRESNICK STERLING EMERGENCY PHYSICIANS OF MARYLAND PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:PINELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-805-1300
Mailing Address - Street 1:PO BOX 827408
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-7408
Mailing Address - Country:US
Mailing Address - Phone:904-805-1300
Mailing Address - Fax:904-805-1302
Practice Address - Street 1:501 S UNION AVE
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3409
Practice Address - Country:US
Practice Address - Phone:443-843-5000
Practice Address - Fax:904-805-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD610061901OtherDEPARTMENT OF LABOR
MDH320DROtherBLUE SHIELD
MD051831001Medicaid
MDCA8891OtherRAILROAD MEDICARE
MDJ949OtherDC BLUE CROSS
MDH320DROtherBLUE SHIELD
MD610061901OtherDEPARTMENT OF LABOR