Provider Demographics
NPI:1649512690
Name:COURTIN, STEPHEN ORION (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ORION
Last Name:COURTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ORION
Other - Middle Name:
Other - Last Name:COURTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5601 LOCH RAVEN BLVD
Mailing Address - Street 2:RUSSEL MORGAN BLDG., SUITE 502
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2945
Mailing Address - Country:US
Mailing Address - Phone:443-444-4720
Mailing Address - Fax:443-444-2110
Practice Address - Street 1:5601 LOCH RAVEN BLVD
Practice Address - Street 2:RUSSELL MORGAN BLDG., SUITE 502
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2945
Practice Address - Country:US
Practice Address - Phone:443-444-4720
Practice Address - Fax:443-444-2110
Is Sole Proprietor?:No
Enumeration Date:2013-03-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0083516207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1006959 00Medicaid