Individual
PHILIP C. DITTMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6110
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-6110
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
D67503
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
417536100
—
MD
01
—
936251-02 & -03
BLUE CROSS BLUE SHIELD
MD
01
—
S062-0350
BC/BS REGIONAL
MD
Enumeration date
02/18/2007
Last updated
02/01/2013
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