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Individual

LEO ISRAEL KOROTKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1205 YORK RD, SUITE 22, LUTHERVILLE, MD 21093-6210
(410) 823-9333
(410) 823-9335
Mailing address
1205 YORK RD, SUITE 22, LUTHERVILLE, MD 21093-6210
(410) 823-9333
(410) 823-9335

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
D0024017
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
218835
MAMSI/ALLIANCE
MD
01
5037
BC/BS
MD
01
S042
BLUE CHOICE/BC/BS FEDERAL
MD
Enumeration date
06/30/2005
Last updated
02/17/2016
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