Provider Demographics
NPI:1619018629
Name:BITZEL, RAYMOND HENRY JR (PT)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:HENRY
Last Name:BITZEL
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WEST RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2326
Mailing Address - Country:US
Mailing Address - Phone:410-321-8684
Mailing Address - Fax:410-321-8644
Practice Address - Street 1:22 WEST RD
Practice Address - Street 2:SUITE 200
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2326
Practice Address - Country:US
Practice Address - Phone:410-321-8684
Practice Address - Fax:410-321-8644
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT3680001OtherBLUECHOICE
MDT3680001OtherFEDERAL EMPLOYEE PROGRAM
MDKS14OtherCAREFIRST NATIONAL ACCOUN
MDKS14OtherCAREFIRST BLUECROSS
MDKS14MS66Medicare ID - Type UnspecifiedPHYSICAL THERAPY