Provider Demographics
NPI:1003927583
Name:EPSTEIN, DAVID GARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GARY
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 N CHARLES ST
Mailing Address - Street 2:GIBSON BLDG., STE. 142
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6872
Mailing Address - Country:US
Mailing Address - Phone:410-828-4846
Mailing Address - Fax:410-938-4444
Practice Address - Street 1:6525 N CHARLES ST
Practice Address - Street 2:GIBSON BLDG., STE. 142
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6872
Practice Address - Country:US
Practice Address - Phone:410-828-4846
Practice Address - Fax:410-938-4444
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2190103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical