Provider Demographics
NPI:1295866333
Name:HERSH, STEPHEN PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PETER
Last Name:HERSH
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 1:2 WISCONSIN CIR
Mailing Address - Street 2:SUITE 650
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-7003
Mailing Address - Country:US
Mailing Address - Phone:301-654-3638
Mailing Address - Fax:301-652-9051
Practice Address - Street 1:2 WISCONSIN CIR
Practice Address - Street 2:SUITE 650
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7003
Practice Address - Country:US
Practice Address - Phone:301-654-3638
Practice Address - Fax:301-652-9051
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0015224174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0015224OtherMEDICAL LICENSE
DCC62393Medicare UPIN
MDD0015224OtherMEDICAL LICENSE