Provider Demographics
NPI:1851437206
Name:LETOURNEAU, STEPHANIE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:LETOURNEAU
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 1:1758 LANIER PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2118
Mailing Address - Country:US
Mailing Address - Phone:202-332-1775
Mailing Address - Fax:
Practice Address - Street 1:700 2ND STREET NE
Practice Address - Street 2:CAPITOL HILL MEDICAL CENTER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002
Practice Address - Country:US
Practice Address - Phone:202-346-3436
Practice Address - Fax:202-346-3499
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035799207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0375179-00Medicaid
DC23723OtherCHARTERED HEALTH
DC5562OtherHEALTH RIGHT MCO
DC0375179-00Medicaid