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Individual

DR. MARK ARTHUR DETTELBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5454 WISCONSIN AVE, SUITE 1535, CHEVY CHASE, MD 20815-6901
(301) 652-8847
(301) 652-8320
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
(410) 500-4266

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
D47278
MD
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MD21258
DC

Other

Enumeration date
02/09/2006
Last updated
06/26/2025
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