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STEPHANIE DETTERLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
201 E UNIVERSITY PKWY, 33RD ST. PROFESSIONAL BLDG, STE 405, BALTIMORE, MD 21218-2829
(410) 554-2284
(410) 554-2184
Mailing address
201 E UNIVERSITY PKWY, 33RD ST. PROFESSIONAL BLDG, STE 405, BALTIMORE, MD 21218-2829
(410) 554-2284
(410) 554-2184

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35089436
OH
207R00000X
Internal Medicine Physician
36113740
IL
207R00000X
Internal Medicine Physician
Primary
D67439
MD
208M00000X
Hospitalist Physician
036113740
IL
208M00000X
Hospitalist Physician
35089436
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200867020
IN
05
2745748
OH
05
36113740
IL
05
7100007510
KY
Enumeration date
02/15/2006
Last updated
11/21/2011
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