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General NPI Number Information
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NPI Number | 1154448389
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Entity Type | Individual
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Provider Name | HENRY COLBURN STEVENSON-PEREZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NCI-NAVY MEDICAL ONCOLOGY NNMC, BUILDING 8, 3RD FLOOR CLINIC
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-435-5336
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Fax |
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Provider Business Mailing Address
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Address Line | 11223 VALLEY VIEW AVE
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City | KENSINGTON
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State | MD
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Zip | 20895-1929
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Country | US
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Telephone | 301-910-0995
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | D0027669
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License Number State | MD
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