Provider Demographics
NPI:1093776353
Name:HANSES, STEPHAN KLAUS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:KLAUS
Last Name:HANSES
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 1:1312 BELMONT ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4812
Mailing Address - Country:US
Mailing Address - Phone:202-299-6100
Mailing Address - Fax:
Practice Address - Street 1:1 SAN DIEGO LOOP
Practice Address - Street 2:NAVAL AIR FACILITY WASHINGTON DC
Practice Address - City:ANDREWS AIR FORCE BASE
Practice Address - State:MD
Practice Address - Zip Code:20762-5518
Practice Address - Country:US
Practice Address - Phone:240-857-2864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME137150207R00000X
VA0101265297207R00000X
GA081458207R00000X
TXS0165207R00000X
DCMD036390207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine