Provider Demographics
NPI:1922557297
Name:EITELMAN, MICHAEL BARRETT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BARRETT
Last Name:EITELMAN
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9000 FRANKLIN SQUARE DR
Mailing Address - Street 2:MEDSTAR FRANKLIN SQUARE MEDICAL CENTER- DEPT OF SURGERY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3901
Mailing Address - Country:US
Mailing Address - Phone:443-777-7520
Mailing Address - Fax:443-777-8196
Practice Address - Street 1:9000 FRANKLIN SQUARE DR
Practice Address - Street 2:MEDSTAR FRANKLIN SQUARE MEDICAL CENTER- DEPT OF SURGERY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:443-777-7520
Practice Address - Fax:443-777-8196
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
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Provider Licenses
StateLicense IDTaxonomies
MDC0006226363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant