Individual
DR. GARY MICHAEL VITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7505 OSLER DR, TOWSON, MD 21204-7736
(410) 337-5337
Mailing address
222 BOSLEY AVE, SUITE C6, TOWSON, MD 21204-4328
(410) 337-5337
(410) 337-5338
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0046107
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050063100
RAILROAD MEDICARE
MD
05
—
160131800
—
MD
01
—
4E67000004
FEDERAL BCBS
—
01
—
53351803
BCBS
—
Enumeration date
10/27/2006
Last updated
06/11/2021
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