Individual
DR. JASON R. DITTRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2002 MEDICAL PKWY, SUITE #235, ANNAPOLIS, MD 21401-3046
(410) 266-2770
(410) 841-6251
Mailing address
2002 MEDICAL PKWY, SUITE #235, ANNAPOLIS, MD 21401-3046
(410) 266-2770
(410) 841-6251
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
D0058803
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10690026
BCBS
MD
01
—
2622593
AETNA HMO/POS
MD
01
—
300134259
RR MEDICARE
MD
05
—
434340900
—
MD
01
—
545L E502
AAD SHIPLEYS
MD
01
—
8317071
AETNA PPO
MD
01
—
E488
AAD AA COUNTY
MD
01
—
G01780A06
AAD PG COUNTY
MD
Enumeration date
10/31/2005
Last updated
11/13/2007
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