Individual
MARK A. LOTTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0214
Mailing address
PO BOX 64358, BALTIMORE, MD 21264-4358
(410) 550-0214
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
D0052025
MD
2085R0202X
Diagnostic Radiology Physician
C1-0009205
DE
2085R0202X
Diagnostic Radiology Physician
Primary
D52025
MD
2085R0202X
Diagnostic Radiology Physician
MD434633
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102192986-0001
—
PA
05
—
1447224654
—
DE
05
—
422900200
—
MD
Enumeration date
02/14/2006
Last updated
01/29/2013
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