Organization
DR ITSCOITZ SEGAL & GRAVINO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL B ITSCOITZ MD (PRESIDENT)
(301) 681-9095
Entity
Organization
Contact information
Practice address
10313 GEORGIA AVENUE, SUITE 307, SILVER SPRING, MD 20902
(301) 681-9095
(301) 681-8156
Mailing address
10313 GEORGIA AVENUE, SUITE 307, SILVER SPRING, MD 20902
(301) 681-9095
(301) 681-8156
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0005568
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58030002
BLUE CROSS DC
—
05
—
779721400
—
MD
01
—
KA62IT
BLUE CROSS MARYLAND
—
Enumeration date
11/29/2006
Last updated
06/12/2008
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