Provider Demographics
NPI:1033279955
Name:HESS, STEPHEN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DAVID
Last Name:HESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WALNUT ST
Mailing Address - Street 2:SUITE 1240
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3523
Mailing Address - Country:US
Mailing Address - Phone:267-687-4437
Mailing Address - Fax:
Practice Address - Street 1:1500 WALNUT ST
Practice Address - Street 2:SUITE 1240
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3523
Practice Address - Country:US
Practice Address - Phone:267-687-4437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433802207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA125630Medicare PIN