Individual
DR. SAMUEL B ITSCOITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12070 OLD LINE CTR STE 303, WALDORF, MD 20602-3535
(301) 645-5100
Mailing address
3100 WYMAN PARK DR, BALTIMORE, MD 21211-2803
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0005568
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0787143
AETNA
—
05
—
206411100
—
MD
01
—
24324
MAMSI
—
01
—
4086234
UNITED HEALTH CARE
—
01
—
58030002
BLUE CROSS DC
—
05
—
779721400
—
MD
01
—
CM6438
RAILROAD MEDICARE
—
01
—
KA62IT
BLUE CROSS MD
—
Enumeration date
09/14/2006
Last updated
01/04/2019
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