Individual
DR. STEPHANIE VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, PHIPPS 160 DEPT. PM&R, BALTIMORE, MD 21287-0005
(410) 502-2447
(410) 614-4033
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6421
(410) 614-4033
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D92762
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D92762
LICENSE
MD
Enumeration date
04/05/2015
Last updated
12/08/2021
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