Provider Demographics
NPI:1922291533
Name:P. L. SITARAS, M.D., P.A.
Entity Type:Organization
Organization Name:P. L. SITARAS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:L
Authorized Official - Last Name:SITARAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-879-3007
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-1133
Practice Address - Street 1:1814 BEL AIR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2734
Practice Address - Country:US
Practice Address - Phone:410-879-3007
Practice Address - Fax:410-877-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014121207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
145583300OtherDEPARTMENT OF LABOR (DOL)
MD204653OtherMEDICARE
MD7904PLOtherCAREFIRST MARYLAND
DCW167 0001OtherCAREFIRST DC
MD7904PLOtherCAREFIRST MARYLAND