Provider Demographics
NPI:1437285855
Name:JEAN, ESTELLE DARLYSE (MD)
Entity Type:Individual
Prefix:
First Name:ESTELLE
Middle Name:DARLYSE
Last Name:JEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ESTELLE
Other - Middle Name:DARLYSE
Other - Last Name:DOCTEUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:MEDSTAR HEALTH CARDIOLOGY ASSOCIATES
Mailing Address - Street 2:1801 PRINCE PHILIP DRIVE, SUITE 4100
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-570-7404
Mailing Address - Fax:301-570-7405
Practice Address - Street 1:MEDSTAR HEALTH CARDIOLOGY ASSOCIATES
Practice Address - Street 2:1801 PRINCE PHILIP DRIVE, SUITE 4100
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-570-7404
Practice Address - Fax:301-570-7405
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0076772207RC0000X
MAL-228259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease