Provider Demographics
NPI:1376742601
Name:STEPHENSON THOMAS, ANN MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
Last Name:STEPHENSON THOMAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9420 KEY WEST AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-251-9555
Mailing Address - Fax:301-309-0765
Practice Address - Street 1:9420 KEY WEST AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-251-9555
Practice Address - Fax:301-309-0765
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08301600207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology