Provider Demographics
NPI:1023445772
Name:AMRITWAR, AMEYA UMAKANT (MD)
Entity type:Individual
Prefix:DR
First Name:AMEYA
Middle Name:UMAKANT
Last Name:AMRITWAR
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 1:4100 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-5506
Mailing Address - Country:US
Mailing Address - Phone:443-364-5500
Mailing Address - Fax:
Practice Address - Street 1:4100 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-5506
Practice Address - Country:US
Practice Address - Phone:443-613-9906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00829402084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine