Individual
DR. ANDRA DAWN DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, SUITE S11C07, BALTIMORE, MD 21201-1544
(410) 328-9909
Mailing address
1202 SOUTHVIEW RD, BALTIMORE, MD 21218-1400
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A103969
CA
207L00000X
Anesthesiology Physician
Primary
D0070662
MD
207R00000X
Internal Medicine Physician
MT188256
PA
Other
Enumeration date
05/30/2007
Last updated
06/07/2021
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