Provider Demographics
NPI:1578630828
Name:HART, STEPHANIE JANEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JANEEN
Last Name:HART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1201 SEVEN LOCKS RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2931
Mailing Address - Country:US
Mailing Address - Phone:240-424-5880
Mailing Address - Fax:240-536-9187
Practice Address - Street 1:1201 SEVEN LOCKS RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2931
Practice Address - Country:US
Practice Address - Phone:240-424-5880
Practice Address - Fax:240-536-9187
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0064340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics