Individual
SHANE J QUITERIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
28155 PATHFINDER CT, SALISBURY, MD 21801-1805
(410) 422-7341
(443) 773-4700
Mailing address
28155 PATHFINDER CT, SALISBURY, MD 21801-1805
(410) 422-7341
(443) 773-4700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C1-0008387
DE
207P00000X
Emergency Medicine Physician
Primary
C7-0003215
DE
207P00000X
Emergency Medicine Physician
MD450838
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102924881
—
PA
01
—
1417089152
BLUE SHIELD
DE
05
—
1417089152
—
DE
Enumeration date
03/09/2007
Last updated
06/25/2021
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