Provider Demographics
NPI:1255486775
Name:KATZ, STEPHEN JAY (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAY
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:31 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2841
Mailing Address - Country:US
Mailing Address - Phone:410-544-5900
Mailing Address - Fax:410-544-5939
Practice Address - Street 1:31 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2841
Practice Address - Country:US
Practice Address - Phone:410-544-5900
Practice Address - Fax:410-544-5939
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD38687207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD293M393FMedicare ID - Type UnspecifiedSTEPHEN KATZ
MDE39454Medicare UPIN