Individual
DR. STEPHEN DOUGLAS SISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 N CAROLINE ST, ROOM 7150G, BALTIMORE, MD 21287-0006
(410) 955-6738
(410) 614-1195
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D44670
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212511100
—
MD
Enumeration date
06/07/2006
Last updated
09/23/2022
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