Basic Information
Provider Information
NPI: 1811173636
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EPSTEIN
FirstName: STEVEN
MiddleName: HOWARD
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 64589
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212644589
CountryCode: US
TelephoneNumber: 4106029343
FaxNumber: 4106022438
Practice Location
Address1: 1838 GREENE TREE RD
Address2: SUITE 400
City: BALTIMORE
State: MD
PostalCode: 212086391
CountryCode: US
TelephoneNumber: 4106027782
FaxNumber: 4106029344
Other Information
ProviderEnumerationDate: 01/10/2008
LastUpdateDate: 09/28/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100XD0066904MDY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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