Provider Demographics
NPI:1689948192
Name:STETLER-STEVENSON, MARYALICE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARYALICE
Middle Name:
Last Name:STETLER-STEVENSON
Suffix:
Gender:F
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:NCI NIH
Mailing Address - Street 2:10 CENTER DR, ROOM 2A33
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-402-1424
Mailing Address - Fax:301-402-0536
Practice Address - Street 1:NCI NIH
Practice Address - Street 2:10 CENTER DR, ROOM 2A33
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-402-1424
Practice Address - Fax:301-402-0536
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035544207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology