Individual
DR. STEPHEN VACCAREZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6240 MONTROSE RD, ROCKVILLE, MD 20852-4119
(301) 231-7111
(301) 231-9040
Mailing address
6240 MONTROSE RD, ROCKVILLE, MD 20852-4119
(301) 231-7111
(301) 231-9040
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D35103
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282111700
—
MD
01
—
8535
BCBS OF NCA
MD
Enumeration date
09/21/2005
Last updated
10/31/2011
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