| Stephanie Durruthy,m.d.,pa | |
|
5074 Dorsey Hall Dr Suite 105 Ellicott City MD 21042-7792 | |
| (410) 992-0272 | |
| (410) 964-0048 |
| Full Name | Stephanie Durruthy,m.d.,pa |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 5074 Dorsey Hall Dr, Ellicott City, Maryland |
| Authorized Official Name and Position | Stephanie Susan Durruthy (OWNER) |
| Authorized Official Contact | 4109920272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Durruthy,m.d.,pa 5074 Dorsey Hall Dr Suite 105 Ellicott City MD 21042-7792 Ph: (410) 992-0272 | Stephanie Durruthy,m.d.,pa 5074 Dorsey Hall Dr Suite 105 Ellicott City MD 21042-7792 Ph: (410) 992-0272 |
| NPI Number | 1578748737 |
|---|---|
| Provider Enumeration Date | 01/07/2008 |
| Last Update Date | 01/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578748737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | D36443 (Maryland) | Primary |
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