Provider Demographics
NPI:1154448389
Name:STEVENSON-PEREZ, HENRY COLBURN (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:COLBURN
Last Name:STEVENSON-PEREZ
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 1:11223 VALLEY VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1929
Mailing Address - Country:US
Mailing Address - Phone:301-910-0995
Mailing Address - Fax:
Practice Address - Street 1:NCI-NAVY MEDICAL ONCOLOGY
Practice Address - Street 2:NNMC, BUILDING 8, 3RD FLOOR CLINIC
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-435-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0027669207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology