Provider Demographics
NPI:1063494771
Name:CLOP, STEPHANIE Y (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:Y
Last Name:CLOP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, STE. 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:703-914-8000
Mailing Address - Fax:410-329-1054
Practice Address - Street 1:24560 SOUTHPOINT DR STE 120
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-3505
Practice Address - Country:US
Practice Address - Phone:703-348-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101234751208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG65904Medicare UPIN
DC012670T99Medicare PIN