Provider Demographics
NPI:1689093296
Name:ESTEPHAN, FAYEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:FAYEZ
Middle Name:
Last Name:ESTEPHAN
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 1:2150 PENNSYLVANIA AVE, NW
Mailing Address - Street 2:DEPT OF HEMATOLOGY AND ONCOLOGY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037
Mailing Address - Country:US
Mailing Address - Phone:202-741-2277
Mailing Address - Fax:
Practice Address - Street 1:2150 PENNSYLVANIA AVE, NW
Practice Address - Street 2:DEPARTMENT OF HEMATOLOGY AND ONCOLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-741-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMD048281207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program