Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 32984 | OK |
N | 111NI0900X | Internist | 32984 | OK |
N | 207R00000X | Internist | D91866 | MD |
N | 111NI0900X | Internist | D91866 | MD |
NPI | 1003343229 |
---|---|
Provider Name | Jesintha Stephenson |
First Address | Middle River, MD 21220-2004 |
Second Address | Baltimore, MD 21287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2017 |
Last Update Date | 09/08/2021 |