Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | D44169 | MD |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | D44169 | MD |
NPI | 1124068721 |
---|---|
Provider Name | Dr. Stephen Ross Shorofsky |
First Address | Baltimore, MD 21264-4442 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 31/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
037160600 | (05) | DC |
1124068721 | (05) | DE |
1805323000 | (05) | WV |
203101900 | (05) | MD |
526957-01 | BLUE CROSS/BLUE SHIELD (01) | MD |
5849608 | (05) | VA |
7610152 | (05) | NC |
E90486 | (02) |