Individual
DR. KEVIN LEE STITELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29466 PINTAIL DR, SUITE 6, EASTON, MD 21601-9323
(410) 822-4220
(410) 822-4462
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6538
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
D48064
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232884
MAMSI
MD
05
—
852121200
—
MD
01
—
E4810003
CAREFIRST BLUECHOICE
MD
Enumeration date
11/07/2005
Last updated
12/08/2013
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